Pregnancy After Hysterectomy: The Intra-Abdominal Pregnancy

An intra-abdominal pregnancy is diagnosed when the fetus is growing outside of the uterus. In most cases, intra-abdominal pregnancy results in loss of the fetus, but there have been cases where the pregnancy was taken to term. Intra-abdominal pregnancy is not a viable solution for women desiring pregnancy after hysterectomy due to the lack of uterus.

When Does an Intra-Abdominal Pregnancy Occur?

When an intra-abdominal pregnancy occurs, the fetus may continue to grow outside of the uterus. This does not mean pregnancy after hysterectomy is an option. In most cases, a previous scar on the uterus ruptures causing the baby to fall into the abdomen. The pregnant woman may not feel the tearing or rupture as it can happen slowly over time. The fetus is still attached to the placenta which is, in turn, attached to the uterus. Pregnancy hormones are flowing in the body from the ovaries and thus, pregnancy after hysterectomy via a fertilized egg implanted in the abdomen is not a viable solution.

In 2007, doctors reported a viable intra-abdominal pregnancy in a woman 32 week gestation. The report was published in the British Journal of Radiology. According to the report, a previous C-section scar had ruptured and the fetus had slid into the abdomen through the hole in the uterus. The placenta grew larger than normal and by 32 weeks, the patient complained of pain radiating through the back.

The intra-abdominal pregnancy was diagnosed after an MRI. A CT scan rose suspicion of an intra-abdominal pregnancy. After the baby was taken via C-section, the female patient underwent an abdominal hysterectomy.

The New England Journal of Medicine reported pregnancy after hysterectomy in a patient just 12 weeks pos surgery. Doctors believed the patient did not report the correct date of the previous menstrual cycle and the pregnancy occurred before the hysterectomy was completed. The egg implanted outside of the uterus and continued to grow to 12 weeks gestation before pain was reported by the patient. The fetus was removed due to potential health risks to the patient.

Pregnancy After Hysterectomy Intra-Abdominal Pregnancy Risks

The risk to a woman with an intra-abdominal pregnancy after hysterectomy far outweighs the viability percentages for the fetus. Hong Kong Journal of Medicine reports only 10 to 25-percent of intra-abdominal pregnancies are viable and of those about 50-percent will not live past the first week after birth. Maternal risk of death varies from 3-percent to 30-percent.