A 14-week abdominal pregnancy after total abdominal hysterectomy.
BACKGROUND
Pregnancy after hysterectomy is rare. Because this clinical phenomenon is so uncommon, the diagnosis is not always considered in the evaluation of pain in a reproductive-aged woman after hysterectomy. Delay in diagnosis can result in potentially catastrophic intra-abdominal bleeding.


METHODS
A 31-year-old multigravida underwent a total abdominal hysterectomy for menometrorrhagia. She experienced several weeks of postoperative abdominal pain and ultimately was diagnosed with a 14-week size intra-abdominal pregnancy. Surgical evacuation of the fetus and products of conception were complicated by significant intra- operative bleeding.


CONCLUSIONS
In reproductive-aged women undergoing hysterectomy, it is vital to obtain preoperative urine hCG levels immediately before surgery and to consider ectopic pregnancy in the differential diagnosis of these women when severe or persistent abdominal pain occurs postoperatively.
Fader
Amanda Nickles
AN
Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. amanditan@yahoo.com
Mansuria
Suketu
S
Guido
Richard S
RS
Wiesenfeld
Harold C
HC
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011269:Pregnancy, Abdominal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014592:Uterine Hemorrhage / Q000601:surgery