Korean J Obstet Gynecol.  2008 May;51(5):584-587.

A case of extratubal secondary trophoblastic implants after laparoscopic treatment of ectopic pregnancy

• Lee JH
• Kim SR

Abstract

Persistent ectopic pregnancy (PEP) is defined as persisting pregnancy after conservative surgical treatment of ectopic pregnancy. PEP usually occurs in the original implantation site after incomplete removal of the trophoblast, but rarely may occur in other sites within the abdominal cavity, i.e., extratubal secondary trophoblastic implantation (ESTI). A 35-year old patient visited our clinic 40 days after laparoscopic surgery for ectopic pregnancy. She was diagnosed with hemoperitoneum and had then undergone a laparotomy procedure. Her operative findings revealed secondary implantation of the trophoblast in her greater omentum, which presented acute bleeding from the ruptured implanted trophoblast. In order to prevent the occurrence of ESTI, management must include minimizing any possible remnant trophoblast during the operative procedure, close and regular follow up of postoperative hCG, and consideration of postoperative prophylactic methotrexate. The patient must be well informed about all possible complications after treatment of ectopic pregnancy.

Keyword

Extratubal secondary trophoblastic implants; Persistent ectopic pregnancy

MeSH Terms

Abdominal Cavity
Female
Follow-Up Studies
Hemoperitoneum
Hemorrhage
Humans
Laparoscopy
Laparotomy
Methotrexate
Oligopeptides
Omentum
Pregnancy
Pregnancy, Ectopic
Surgical Procedures, Operative
Trophoblasts
Methotrexate
Oligopeptides