Tuboovarian pregnancy associated with elevated maternal serum alpha-fetoprotein. A case report.

Tuboovarian implantation is a rare form of pregnancy that is difficult to diagnose in early gestation. A patient with a tuboovarian pregnancy presented with abnormally elevated initial screening maternal serum alpha-fetoprotein (MSAFP). The elevated MSAFP and a pelvic mass of uncertain etiology on ultrasonography delayed the diagnosis until laparotomy was performed. Elevated MSAFP accompanied by oligohydramnios and a pelvic mass is a particularly suspect finding for a tuboovarian or other type of extrauterine implantation.