2024 Volume 40 Issue 2 Pages 120-124
Fallopian tube interstitial pregnancy is a relatively rare condition that occurs in about 1% of all ectopic pregnancies. We report a case of an ipsilateral tubal interstitial pregnancy after a left fallopian tube pregnancy treated by laparoscopic salpingectomy. The patient was 28 years old, had experienced 5 pregnancies and 2 deliveries, and underwent a laparoscopic left salpingectomy for a left fallopian tube pregnancy in February. Her blood hCG level became negative postoperatively, and her menstruation resumed in March. In April, she visited her primary care physician because of a positive pregnancy test. Her blood hCG level had risen to 5,072 mIU/ml, but since no fetal sac was found in the uterus, she was referred to our hospital on suspicion of an ectopic pregnancy. Transvaginal ultrasonography at our hospital revealed a fetal sac in the left adnexal region, and an emergency surgery was planned due to a suspected peritoneal pregnancy in the left fallopian tube mesentery. Intraoperative findings showed that the pregnancy tissue was enlarged from the left fallopian tube stroma and partially adhered to the fallopian tube mesentery. The surgery was completed by resecting the pregnancy tissue such that a portion of the stroma was cut away. The pathological results of the specimen showed chorionic villi and some endometrial tissue, leading to an estimation that the embryo was fertilized in the right fallopian tube, passed through the uterine lumen, and implanted in the left fallopian tube stroma after tubectomy. Considering that tissue-repairing mediators can play a supportive role in embryo implantation, the healing process after the previous ectopic pregnancy possibly induced embryo implantation at the site of tubal resection. Postoperatively, blood hCG levels quickly decreased, and after one month, the blood hCG level became negative.
