{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T07:56:11Z","timestamp":1773215771221,"version":"3.50.1"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>An ectopic pregnancy (EP) occurs when the blastocyst implants outside the endometrial lining of the uterine cavity. The loss of fertility poses a dilemma in the radical treatment of ruptured ectopic pregnancy. This case report is presented in line with the SCARE criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 36-year-old woman, G3P1 + 1 L1, at 8 weeks of gestation, presented with lower abdominal pain that was localized in the left iliac region. The pain was not associated with per vaginal spotting or bleeding. Pelvic ultrasonography revealed a significant fluid collection in the pouch of Douglas. A left salpingectomy was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>A history of one ectopic pregnancy increases the risk of a subsequent EP by approximately 10 %, while having more than one previous ectopic pregnancy raises the risk to around 25 %. In communities where reproduction is believed to be an essence of womanhood, the loss of fertility carries serious socio-cultural consequences. These include not only external stigma but also internalized self-stigma that presents a significant dilemma when considering definitive treatment for a recurrent contralateral ruptured EP in a patient with a prior salpingectomy, particularly in low-resource settings, where IVF-ET and egg\/embryo freezing are costly or unavailable. Surgical management of recurrent EP does not significantly impact the outcomes of IVF-ET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A patient who refuses salpingectomy after a recurrent ruptured EP faces a dilemma between preserving autonomy and preventing potentially life-threatening complications. A comprehensive approach should include discussions about alternative fertility options, patient education, psychological support, and ensuring that all decisions are fully informed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111507","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T13:58:58Z","timestamp":1750255138000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["A clinical dilemma for fertility preservation in a woman with unilateral salpingectomy followed by contralateral ruptured ectopic pregnancy. A case report"],"prefix":"10.1097","volume":"133","author":[{"given":"Constantin Mukeba","family":"Mpoyi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Mashyaka","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Obstetrics and Gynecology at Muhimbili National Hospital\/Upanga, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halima","family":"Mbwambo","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Obstetrics and Gynecology at Muhimbili National Hospital\/Upanga, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillipo Pius","family":"Gone","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Obstetrics and Gynecology at Muhimbili National Hospital\/Upanga, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herv\u00e9 Tshikomba","family":"Mbuyamba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"4","key":"R2-10-20260310","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1136\/jfprhc-2011-0073","article-title":"Diagnosis and management of ectopic pregnancy","volume":"37","author":"Sivalingam","year":"2011","journal-title":"J. Fam. Plan Reprod. Heal. Care"},{"issue":"1","key":"R3-10-20260310","first-page":"1","article-title":"Prevalence and related factors of rupture among cases with ectopic pregnancy; a systematic review and meta-analysis","volume":"12","author":"Xu","year":"2024","journal-title":"Arch. Acad. Emerg. Med"},{"key":"R4-10-20260310","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ejogrb.2021.01.054","article-title":"Increase rate of ruptured tubal ectopic pregnancy during the COVID-19 pandemic","volume":"259","author":"Dvash","year":"2021","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol. [Internet]"},{"key":"R6-10-20260310","article-title":"Revised Surgical CAse REport (SCARE) guideline: an update for the age of artificial intelligence","volume":"10","author":"Kerwan","year":"2025","journal-title":"Premier J. Sci"},{"issue":"3","key":"R7-10-20260310","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1002\/uog.1822","article-title":"Non-surgical management of live ectopic pregnancy with ultrasound-guided.pdf","volume":"25","year":"2005","journal-title":"Ultrasound Obstet. Gyne"},{"issue":"2","key":"R8-10-20260310","doi-asserted-by":"crossref","first-page":"166","DOI":"10.4103\/2141-9248.113655","article-title":"An appraisal of the management of ectopic pregnancy in a Nigerian tertiary hospital","volume":"3","author":"Igwegbe","year":"2013","journal-title":"Ann. Med. Health Sci. Res"},{"key":"R9-10-20260310","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ejogrb.2020.08.046","article-title":"Ectopic pregnancy following in vitro fertilization after bilateral salpingectomy: a review of the literature","volume":"254","author":"OuYang","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol. 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