Images in Clinical Medicine
Intraabdominal Pregnancy after Hysterectomy
N Engl J Med 2003; 349:1534October 16, 2003
- Article
A 31-year-old woman underwent total abdominal hysterectomy for menorrhagia. Her reported last menstrual period had occurred six days before surgery. Twelve weeks after surgery, computed tomography of the abdomen and pelvis was performed because of persistent abdominal pain and revealed an intraabdominal pregnancy. The crown–rump length of the fetus was 6.3 cm, consistent with a gestation of 12 weeks and 5 days (±7 days). Laparotomy confirmed the intraabdominal pregnancy and showed placental tissue implanted on the broad ligament and ovary. The fetus was removed, and the patient was transferred to our institution, where she recovered without further treatment. We hypothesize that conception had occurred during the 10 days before surgery and that the reported date of the last menses was incorrect. Implantation may have occurred directly on a peritoneal surface, or the embryo may have been in the fallopian tube (having been implanted there or traveling within the lumen en route to the uterus) and subsequently been transferred to the peritoneal cavity before, during, or after the hysterectomy.
Harold C. Wiesenfeld, M.D.
Richard S. Guido, M.D.
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213-3180- Citing Articles (2)
- Letters
