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A heterotopic pregnancy is a complication of pregnancy in which both extrauterine pregnancy and intrauterine pregnancy occur simultaneously. [2] It may also be referred to as a combined ectopic pregnancy, multiple‑sited pregnancy, or coincident pregnancy. The most common site of the extrauterine pregnancy is the fallopian tube.
Salpingectomy was performed by Lawson Tait in 1883 in women with a bleeding ectopic pregnancy; it is now established as a routine and lifesaving procedure [clarification needed]. Other indications for a salpingectomy include infected tubes (as in a hydrosalpinx) or as part of the surgical procedure for tubal cancer. [citation needed]
The most commonly addressed by Catholic bioethicists is extrauterine tubal pregnancies in which salpingectomy is seen with consensus to be indirect while some claim salpingostomy and methotrexate to be indirect. [9] [10] [11] Of the other 7-10% of ectopic pregnancies, there are interstitial pregnancy and cesarean scar pregnancy.
Two of these surgeries include Salpingectomy and Salpingostomy. The Salpingectomy procedure is the removal of a fallopian tube while in Salpingostomy an opening is created into the fallopian tube. A study found that patients that undergo these procedures have a similar recurrent ectopic pregnancy rate. 5% for Salpingectomy and 8% for salpingostomy.
Prophylactic salpingectomy is a preventative surgical technique performed on patients who are at higher risk of having ovarian cancer, such as individuals who may have pathogenic variants of the BRCA1 or BRCA2 gene. [1]
Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. [5] Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. [1] The pain may be described as sharp, dull, or crampy. [1]
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The most common techniques for partial bilateral salpingectomy are the Pomeroy [20] or Parkland [21] procedures. The ten year pregnancy rate is estimated at 7.5 pregnancies per 1000 procedures performed, and the ectopic pregnancy rate is estimated at 1.5 per 1000 procedures performed. [5]