Repeated ectopic pregnancy after homolateral salpingectomy

The obstetrical prognosis for patients after two ectopic pregnancies is very poor, especially when the second pregnancy is implanted on the stump of a resected tube or in the uterine cornu after previous total salpingectomy with wedge cornual resection. The most probable mechanism of implantation of the second ectopic pregnancy seems to be external migration of the fertilized ovum, but there may have been internal migration. The reproductive implications of a repeated ectopic pregnancy should never be overlooked and depend to a certain measure on the technic used in the treatment of the first ectopic pregnancy, whether simple or total salpingectomy or salpingotomy. It is important to evaluate every woman with a missed period and abdominal pain for an ectopic pregnancy, even if she had an ectopic pregnancy in the past. A case of successful twin pregnancy following repeated ectopic pregnancy after homolateral salpingectomy is presented.