| Is Serum Human Chorionic Gonadotrophin Follow-Up Necessary after Suspected Spillage of Trophoblast at the Time of Laparoscopic Surgery for Ectopic Pregnancy? | |
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MedLine Citation:
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PMID: 21160149 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: Persistent trophoblast is a recognised complication of salpingostomy for the treatment of ectopic pregnancy, with reported rates of 3-20%; hence, women are advised to have serum human chorionic gonadotrophin (hCG) levels monitored post-operatively. Although much less common, there are also reports of disseminated trophoblastic peritoneal implants after laparoscopic salpingectomy. The aim of this study was to assess whether monitoring of post-operative serum hCG levels is necessary in women undergoing salpingectomy, where intra-operative spillage of trophoblast is thought to have occurred. Methods: This was a retrospective study of women who underwent serum hCG follow-up after salpingectomy. Serum hCG levels were monitored if: (1) the ectopic pregnancy was found to be ruptured; (2) there was a significant haemoperitoneum (>500 ml); (3) there was thought to be spillage of trophoblast at the time of salpingectomy or (4) a tubal miscarriage was diagnosed. Serum hCG levels were taken at days 1-2, days 3-4, days 6-8 or days 13-15 post-surgery. Women were followed up until the serum hCG level was <15 IU/l. Persistent trophoblast was defined as a failure of the serum hCG level to decrease spontaneously after surgery. Results: 105 women underwent serum hCG follow-up after a laparoscopy for a tubal ectopic pregnancy. Of these women, 92 had a laparoscopic salpingectomy and 13 were diagnosed with a tubal miscarriage at the time of laparoscopy. In all women the serum hCG decreased spontaneously. Conclusion: It does not appear necessary to routinely monitor serum hCG levels post-operatively in women diagnosed with tubal miscarriages, in those undergoing salpingectomy for a ruptured ectopic pregnancy or in cases of salpingectomy, where there is thought to be spillage of trophoblast. |
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Authors:
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Shabana A Bora; Emma Kirk; Anneleen Daemen; Dirk Timmerman; Tom Bourne |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-12-15 |
Journal Detail:
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Title: Gynecologic and obstetric investigation Volume: - ISSN: 1423-002X ISO Abbreviation: - Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7900587 Medline TA: Gynecol Obstet Invest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2010 S. Karger AG, Basel. |
Affiliation:
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Early Pregnancy and Gynaecological Ultrasound Unit, St George's, University of London, London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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