Severe bleeding from peritoneal implants of trophoblastic tissue after laparoscopic salpingostomy for ectopic pregnancy.

ABSTRACT

OBJECTIVE: To describe a case of persistent trophoblastic tissue after conservative laparoscopic treatment of an ectopic pregnancy (EP). DESIGN: Case report. SETTING: University hospital. PATIENT A 19-year-old nulliparous woman, presenting 30 days after conservative laparoscopic treatment of an EP. INTERVENTION(S) Emergency laparotomy, histologic examination of excised trophoblastic tissue, serial beta-hCG levels. MAIN OUTCOME MEASURE(S) Serum beta-hCG clearance curves after surgical treatment of an EP. RESULT(S) Histology confirmed multiple peritoneal implants of trophoblastic tissue, mainly situated on the sigmoid colon and the omentum majus. Serial beta-hCG levels decreased rapidly from 1,394 to 0 mU/L within 17 days. CONCLUSION(S) After conservative treatment of EP, patients should be followed up clinically and serial beta-hCG measurements should be obtained to ensure the absence of persistent trophoblastic tissue.