Ectopic Pregnancy After Hysterectomy: Impossible

A tubal (ectopic) pregnancy cannot occur after total hysterectomy.

Anatomic Reason

• Hysterectomy removes the uterus, fallopian tubes (salpingectomy), and often cervix.
• Without fallopian tubes, there is no site for fertilization or tubal implantation.
• Ovaries may remain (if oophorectomy not performed) and ovulate, but ova are released into peritoneal cavity and resorbed.

Rare Exceptions (Not True Tubal Pregnancy)

• Ovarian pregnancy: Implantation on ovarian surface (extremely rare).
• Abdominal pregnancy: Implantation on peritoneal surfaces, bowel, omentum (requires at least one patent tube for sperm transport; theoretically possible after supracervical hysterectomy with tubes left).
• Stump ectopic: Residual tubal/uterine remnant if subtotal hysterectomy.

Clinical Bottom Line

After total hysterectomy with bilateral salpingectomy, ectopic pregnancy is anatomically impossible. Any positive pregnancy test post‑hysterectomy warrants investigation for hCG‑secreting tumor or lab error.