Ruptured ectopic pregnancy after tubal sterilization: case report

Abstract

Introduction:  bilateral tubal sterilization is a method of contraception, and pregnancy after sterilization is uncommon.

Description:  we present the case of a ruptured ectopic pregnancy following postpartum vaginal tubal sterilization. A 33-year-old woman was admitted after presenting lower abdominal pain for 4 days and amenorrhea for 8 weeks, four pregnancies, four vaginal deliveries, and surgical sterilization using the Pomeroy technique performed during her last delivery seven years ago. The patient was β-subunit positive, and a transvaginal ultrasound showed an empty uterus, a heterogeneous mass measuring 55 x 44 mm below the right ovary, and the presence of abundant fluid. Based on the clinical signs, pregnancy test, and imaging, a right ectopic pregnancy was suspected. An exploratory laparotomy was performed, revealing dark clots and blood, a 2500 cc hemoperitoneum, and a 4 x 5 cm mass on the distal stump with active bleeding at the fimbriae.

Discussion:  the cause of the ectopic pregnancy after tubal sterilization remains uncertain. The surgical sterilization technique and age at sterilization influence the likelihood of an ectopic pregnancy occurrence.

Key words
Ectopic pregnancy; Tubal sterilization; Tubal pregnancy