BackgroundEctopic pregnancy after hysterectomy is a very rare condition, but it must be kept in mind in women with history of hysterectomy who present with abdominal pain and ecographic adnexal heterogeneous images. Since first described by Wendeler in 1895, at least 67 ectopic pregnancies (tubal, ovarian and abdominal) have been described in patients subjected to prior hysterectomy.Case presentationWe describe the case of a 41-year-old white caucasian woman admitted to the emergency room due to abdominal pain for two days. The ultrasounds scan and the quantification of beta-HCG led to the diagnosis of tubal ectopic pregnancy, although she had been hysterectomized two years before. An emergency laparoscopy was performed for salpingectomy. The pathology report indicated trophoblastic tubal implantation and hematosalpinx.ConclusionsEctopic pregnancy is one of the conditions to be considered in the differential diagnosis of abdominal pain in women of child bearing potential, and the absence of the uterus does not rule out its diagnosis.
Intestinal obstruction is an uncommon surgical emergency during pregnancy that affects seriously the prognosis of gestation. The underlying cause can be identified in the majority of cases and usually consists of adhesions secondary to previous abdominal or pelvic surgery, followed in order of frequency by intestinal volvuli. In recent years there have been no reports in which the gravid uterus has been the cause of intestinal obstruction. We report the case of a woman in week 33 + 4 of pregnancy who developed extrinsic compression of the colon secondary to uterine rotation and pelvic impaction of the head of the fetus.
For centuries it has been considered that the due date for delivery in our species is 280 days after the onset of the last menstruation. However, in most cases this statement is not accurate. The main objective of this study was to determine the mean duration of pregnancy in our setting and whether it has experienced changes in recent years. A retrospective, population-based descriptive study was made of 102,169 deliveries assisted in Malaga University Hospital (Malaga, Andalusia, Spain) during the period 1998-2015. The mean gestational age at delivery was 269 days (SD 16 days), with a modal gestational age of 273 days. The mean duration of the singleton and multiple pregnancies was 271 days (SD 17 days) and 242 days (SD 20 days), respectively. A significant shortening of the duration of pregnancy was observed in the course of the study period.
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