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Clinical case of ectopic pregnancy in the fallopian tube stump

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.095

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Abstract

Here we describe a rare clinical case of female with a history of surgical sterilization coupled to ectopic pregnancy in the fallopian tube stump, comprising on average 1.19 % of total ectopic pregnancies. The patient E. was admitted to the gynecological department complaining of aching pain in the lower left abdominal quadrant, blood discharge from the genital tract, and delayed menstruation. Due to a previous operation for sterilization, no onset of pregnancy was expected. A positive urinary test for human chorionic gonadotropin was obtained, whereas ultrasound examination did not reliably confirm the onset of pregnancy. However, taking into account the ultrasound signs of the hematoperitoneum, a culdocentesis was performed that revealed dark liquid non-clotting blood. Laparoscopic surgery was performed on emergency indications. Intraoperatively: the stump of the left fallopian tube was dilated, cyanotic, and blood was leaking from the fimbria lend. Bilateral excision of fallopian tube stumps was performed. The primary clinical diagnosis was interrupted left-sided tubal pregnancy (in the fallopian tube stump) that was confirmed by pathomorphological examination. Thus, the clinical case described by us demonstrates properly conducted differential diagnostics as well as timely management and therapeutic interventions. Hence, previous surgical sterilization recorded in patient history should not rule out a diagnosis of ectopic pregnancy.

About the Authors

A. N. Sulima
Medical Academy named after S. I. Georgievsky, V. I. Vernadsky Crimean Federal University; Simferopol Clinical Maternity Hospital № 1
Russian Federation

Anna N. Sulima – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatology № 1, Medical Academy named after S. I. Georgievsky, V. I. Vernadsky Crimean Federal University; Obstetrician-Gynecologist, Simferopol State Clinical Maternity Hospital № 1

5/7 Lenin Boulevard, Simferopol, Republic of Crimea 295006



D. A. Beglitse
Medical Academy named after S. I. Georgievsky, V. I. Vernadsky Crimean Federal University; Simferopol Clinical Maternity Hospital № 1
Russian Federation

Dmitriy A. Beglitse – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatology № 1, Medical Academy named after S. I. Georgievsky, V. I. Vernadsky Crimean Federal University; Chief Physician, Simferopol Clinical Maternity Hospital № 1

5/7 Lenin Boulevard, Simferopol, Republic of Crimea 295006



A. N. Rybalka
Medical Academy named after S. I. Georgievsky, V. I. Vernadsky Crimean Federal University
Russian Federation

Anatoliy N. Rybalka – MD, Dr Sci Med, Academician of the Crimean Academy of Sciences, Professor, Department of Obstetrics, Gynecology and Perinatology № 1

5/7 Lenin Boulevard, Simferopol, Republic of Crimea 295006



P. N. Baskakov
Medical Academy named after S. I. Georgievsky, V. I. Vernadsky Crimean Federal University
Russian Federation

Petr N. Baskakov – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatology № 1

5/7 Lenin Boulevard, Simferopol, Republic of Crimea 295006



I. O. Kolesnikova
Medical Academy named after S. I. Georgievsky, V. I. Vernadsky Crimean Federal University
Russian Federation

Inna O. Kolesnikova – MD, Resident, Department of Obstetrics, Gynecology and Perinatology № 1

5/7 Lenin Boulevard, Simferopol, Republic of Crimea 295006



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For citation:


Sulima A.N., Beglitse D.A., Rybalka A.N., Baskakov P.N., Kolesnikova I.O. Clinical case of ectopic pregnancy in the fallopian tube stump. Obstetrics, Gynecology and Reproduction. 2020;14(2):239-244. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.095

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)