Persistent ectopic syndrome.

Persistent ectopic syndrome is a complication of conservative surgery for tubal pregnancy. This study is directed toward the escalating conservatism in the treatment of tubal ectopic pregnancy and its possible sequelae. Residual trophoblast propagation after initial surgery is becoming more frequent. Two cases are reported. The first woman was admitted with an acute abdomen; salpingectomy was performed to control hemorrhage from tubal rupture at the site of the previous salpingostomy. The second woman was treated by fimbrial expression. Because of the recurrence of pain, the beta human chorionic gonadotropin (BHCG) levels were measured; they indicated fresh trophoblastic activity. She was treated with methotrexate orally, 10 mg/d for 5 days. The need for BHCG surveillance of conservatively managed tubal ectopic pregnancy is stressed. The value of using methotrexate when tubal integrity persists is discussed in the light of its traditional role against trophoblastic tumours.