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

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.