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  • Title: Heterotopic pregnancy following bilateral tubal ligation: case report.
    Author: Kumbak B, Ozkan ZS, Simsek M.
    Journal: Eur J Contracept Reprod Health Care; 2011 Aug; 16(4):319-21. PubMed ID: 21542670.
    Abstract:
    CASE REPORT: A 38-year-old woman presented, one year after bilateral tubal ligation, with vaginal bleeding, vomiting, and stupor. Ten days earlier, she had submitted to a dilatation and curettage for an unexpected intrauterine pregnancy. At the time of this presentation there was rebound tenderness and guarding on abdominal examination, and a 2.5 cm right adnexal mass was detected on transvaginal ultrasound together with free fluid in the pelvis. The serum level of beta-hCG was 8522 mIU/ml. At laparoscopy a right tubal pregnancy and a large haematocele in the pouch of Douglas were detected. A right salpingectomy and a bipolar electrocoagulation of the left tubo-cornual junction were performed laparoscopically. CONCLUSION: Pregnancy after tubal sterilisation may be heterotopic and this possibility should be considered in the differential diagnosis.
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