Ruptured ectopic pregnancy after tubal sterilization: case report

Pantigoso-Gutierrez D.F.; Oscátegui-Peña M.E. · Revista Brasileira de Saude Materno Infantil (2025) · DOI: 10.1590/1806-9304202500000160-en

Resumen

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.

Instituciones: Universidad Nacional Federico Villarreal; Universidad Peruana Unión