**4.3 Conclusion and management**

Tubal ectopic pregnancy accounts for approximately 1% of all pregnancies. Term tubal pregnancy, however is extremely rare. Review of the literature revealed that at least over 12 cases of term tubal pregnancy have been reported. Most of them were published in the 1950s [1–11]. The most recent article on this subject was published by us in 2010 [12]. With the recent advances in ultrasound and diagnostic imaging, it would be quite rare for ectopic pregnancy to reach up to term. In the event this would happen, an urgent laparotomy and salpingectomy with the removal of the affected fallopian tube would be the recommended option. Figure 1 and 2 demonstrate term tubal ectopic pregnancy with normal uterus and dilated fallopian tube after surgically opening it (figure 4.1). Then the term macerated fetus inside the tube (figure 4.2).

Fig. 4.1. Reatained term tubal pregnancy

 McElin and Randal (2) established 4 criteria of tubal pregnancy near or at term without rupture of the tube: 1) that comp lete extirpation of the fetal sac and products of conception be achieved by salpingectomy 2) that there be no gross or microscopic evidence of tubal rupture, 3) that ciliated columner epithelium be demonstrated at a few points in the inner lining of the sac and 4) that smooth muscle be found in the sac wall at multiple sites and at

Tubal ectopic pregnancy accounts for approximately 1% of all pregnancies. Term tubal pregnancy, however is extremely rare. Review of the literature revealed that at least over 12 cases of term tubal pregnancy have been reported. Most of them were published in the 1950s [1–11]. The most recent article on this subject was published by us in 2010 [12]. With the recent advances in ultrasound and diagnostic imaging, it would be quite rare for ectopic pregnancy to reach up to term. In the event this would happen, an urgent laparotomy and salpingectomy with the removal of the affected fallopian tube would be the recommended option. Figure 1 and 2 demonstrate term tubal ectopic pregnancy with normal uterus and dilated fallopian tube after surgically opening it (figure 4.1). Then the term macerated fetus

**4.2 Diagnosis** 

considerable distances from normal, undilated tube.

**4.3 Conclusion and management** 

inside the tube (figure 4.2).

Fig. 4.1. Reatained term tubal pregnancy

Fig. 4.2. Reatained term tubal pregnancy
