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

Lee, Jung Han; Kim, Seung Ryong

Case Report

Korean Journal of Obstetrics & Gynecology 2008;51(5):584-587.
Published online May 1, 2008.

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

Jung Han Lee, Seung Ryong Kim

Department of Obstetrics and Gynecology, College of Medicine,Hanyang University, Seoul, Korea. kimsr@hanyang.ac.kr

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.

Key Words: Extratubal secondary trophoblastic implants, Persistent ectopic pregnancy