Rupture of an unsuspected ectopic pregnancy following a hyst
Hysterosalpingography (HSG) is routinely performed in the mid-follicular phase of a woman’s menstrual cycle for cavity and tubal patency assessment as a part of the infertility screening.

A pre-procedural pregnancy test is not routinely required unless the patient reports abnormal menstrual bleeding or irregular menstrual pattern.

Published in the International Journal of Surgery Case Reports, the authors present the case of a 29 year-old sub fertile woman who had a HSG performed on day 12 of her menstrual cycle.

She developed abdominal pain shortly after and was diagnosed with a ruptured ectopic pregnancy, resulting in a right salpingectomy. The patient was discharged well 3 days later.

• HSG should be scheduled during the follicular phase, between Day 5 and Day 12 of a 28 days menstrual cycle and only after menstrual flow has stopped.

• The patient should practice safe sex during the cycle where HSG is performed.

• The patient should be informed about the small risk of undetected pregnancy that could lead to serious complications once the HSG is done such as increased morbidity, invasive surgical operation and reduced fertility.

• Women having cycles shorter than 21 days or longer than 35 days (regardless of their regularity), having unreliable menstrual history and/or unusual menstrual flow pattern, must proceed for a pre-procedural pregnancy test.

• Units should consider whether universal pre-procedural pregnancy testing should be implemented. At present, there is insufficient evidence to recommend it.

Read about the case in detail here:
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