Persistent omental trophoblastic implantation following salpingostomy, salpingectomy and methotrexate for ectopic pregnancy: A case report

Robson, Danielle; Lusink, Vanessa; Campbell, Neil

doi:10.1016/j.crwh.2019.e00095

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…However, it is advised to do serial B-HCG measurements after methotrexate or salpingotomy to confirm completion of treatment 5 7. Most cases that have been reported so far in the literature, were related to salpingotomy rather than salpingectomy 8. Yet, we managed to present a summary of literature review for all cases with persistant ectopic pregnancy after salpingectomy(table 1).…”

Section: Discussionmentioning

confidence: 99%

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Methotrexate treatment for peritoneal trophoblastic implants after laparoscopic salpingectomy and secondary laparoscopic excision of ectopic pregnancy

Maher,

Fairley,

Khatri

et al. 2024

BMJ Case Rep

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Ectopic pregnancy is a one of the primary causes of maternal mortality in first trimester. The most common site of ectopic pregnancy is the fallopian tube. Surgical management of tubal ectopic pregnancy includes salpingotomy or salpingectomy. Persistent ectopic pregnancy can happen after salpingotomy due to incomplete removal of ectopic tissue. However, it is very rare after salpingectomy. In our case, the patient had right-sided salpingectomy and histology confirmed right-sided tubal ectopic pregnancy. She presented 19 days’ later with abdominal pain, haemoperitoneum and persistent high beta-HCG (B-HCG). A second laparoscopy was done and tissue implants were removed from the surface of the right ovary and the omentum, which were confirmed to be products of conception on histology. The pain settled postoperative. However, B-HCG remained high postoperative. Subsequently, methotrexate treatment was given leading to full resolution of the pregnancy with one dose.

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Section: Discussionmentioning

confidence: 99%

“…In another case, salpingotomy was attempted but ended with salpingectomy in the same procedure, the patient presented later with pain and high BHCG and received methotrexate treatment. However, she developed intra-abdominal bleeding after that and had a laparoscopy to control the bleeding and remove the implants 8…”

Section: Discussionmentioning

confidence: 99%

Methotrexate treatment for peritoneal trophoblastic implants after laparoscopic salpingectomy and secondary laparoscopic excision of ectopic pregnancy

Maher,

Fairley,

Khatri

et al. 2024

BMJ Case Rep

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“…The need for a second laparoscopy should be based on symptoms rather than changes in concentrations of human chorionic gonadotrophin. In a randomised controlled trial, methotrexate together with laparoscopic salpingostomy was found effective in reducing the complication of persistent trophoblast [43] .…”

Section: Surgicalmentioning

confidence: 99%

Incidence, diagnosis and management of ectopic pregnancies: A review

Pillai¹,

Rs²

2020

Int. J. Clin. Obstet. Gynaecol.

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Background: Ectopic pregnancy; the conceptus implanting outside the uterine cavity, arises in 1.3-2.4% of all pregnancies which put the lives of many young women in peril. It causes major maternal morbidity and mortality and its incidence is increasing worldwide. Though the set medical practices to address the grave situation are improved, it still remains worrying to note in third world countries. Methods: We review the incidence, causes, diagnosis, and management of ectopic pregnancy. The evidence presented is from a combination of selected published papers identified from Medline and a reflection of clinical practice in our unit. Results: Diagnosis involves a combination of clinical symptoms, serology, and ultrasound. Medical management with methotrexate is an effective option in most clinically stable patients. Patients, who have failed medical management or presented with ruptured ectopic pregnancy are most frequently managed with excision by laparoscopy or, less commonly, laparotomy. Following tubal ectopic pregnancy, the rate of subsequent intrauterine pregnancy is high and independent of treatment modality. Conclusion: This review describes the incidence, risk factors, diagnosis, and management of tubal and non-tubal ectopic pregnancies, and reviews the existing data regarding recurrence and future fertility.

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Primary Omental Pregnancy Masquerading as Acute Abdomen: A Case Report

Sarumathy

Raj²

2022

J Obstet Gynecol India

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Persistent omental trophoblastic implantation following salpingostomy, salpingectomy and methotrexate for ectopic pregnancy: A case report

Cited by 6 publications

References 16 publications

Methotrexate treatment for peritoneal trophoblastic implants after laparoscopic salpingectomy and secondary laparoscopic excision of ectopic pregnancy

Methotrexate treatment for peritoneal trophoblastic implants after laparoscopic salpingectomy and secondary laparoscopic excision of ectopic pregnancy

Incidence, diagnosis and management of ectopic pregnancies: A review

Primary Omental Pregnancy Masquerading as Acute Abdomen: A Case Report

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