Ectopic pregnancy after hysterectomy study: A systematic review of published case reports comparing ectopic pregnancy following total and supracervical hysterectomy

Authors

Awoniyi Awonuga, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Solomon Agboroko, Rochester Regional HealthFollow
Daniel Moussa, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Richard Hsu, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Megan Fee, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Jeenal Shah, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Sakshi Das, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Chinyere Nnaji, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA.
Olivia G. Camp, Department of Obstetrics and Gynecology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, Michigan, USA.
Michael Diamond, Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA.

Department

OB/GYN

Document Type

Article

Publication Title

The Journal of Obstetrics and Gynaecology Research

Abstract

Purpose: To perform a systematic review of all published case reports and compare ectopic pregnancy following total versus supracervical hysterectomy.

Methods: Published case reports of patients with ectopic pregnancy following hysterectomy up to July 12, 2024, were searched using PubMed, Google Scholar, Embase, Scopus, and Web of Science databases using the terms "post-hysterectomy ectopic pregnancy," OR "pregnancy after hysterectomy." Manuscripts with case reports of ectopic pregnancy following previous hysterectomy were statistically analyzed. Categorical variables were analyzed using the chi-squared or Fisher's exact test and continuous variables by independent t-test and Wilcoxon rank sum test. A p-value < 0.05 determined statistical significance.

Main results: One hundred and eight cases reported by 106 authors were eligible for analysis. Of these, 34 underwent supracervical and 74 total hysterectomies. There were no differences between the two groups in the demographic variables, symptoms, and status of patients at presentation. Patients with a history of supracervical, unlike total hysterectomy, were less likely to have their pregnancy associated with the period just before or shortly after hysterectomy (termed the peri-hysterectomy period) (OR 0.18, 95% CI [0.06-0.54], p < 0.001). However, they are more likely to have a diagnosis of possible ectopic pregnancy before surgery (OR 3.56, 95% CI [1.45-8.73], p = 0.007).

Conclusion: Physicians should be aware that ectopic pregnancy following a supracervical, unlike total hysterectomy, occurs more often remote from the peri-hysterectomy period and should include ectopic pregnancy in their differential diagnosis of abdominal and pelvic pain in all previously hysterectomized patients.

First Page

e16268

DOI

10.1111/jog.16268

Volume

51

Issue

4

Publication Date

4-1-2025

Medical Subject Headings

Humans; Female; Hysterectomy (adverse effects); Pregnancy; Pregnancy, Ectopic (surgery, etiology); Adult

PubMed ID

40150941

Recommended Citation

Awonuga, A., Agboroko, S., Moussa, D., Hsu, R., Fee, M., Shah, J., Das, S., Nnaji, C., Camp, O. G., & Diamond, M. (2025). Ectopic pregnancy after hysterectomy study: A systematic review of published case reports comparing ectopic pregnancy following total and supracervical hysterectomy. The Journal of Obstetrics and Gynaecology Research, 51 (4), e16268. https://doi.org/10.1111/jog.16268