Early and late half-life of human chorionic gonadotropin as a predictor of persistent trophoblast after laparoscopic conservative surgery for tubal pregnancy.
A case report is presented of an ampullary ectopic pregnancy which was treated by salpingostomy. Twenty-six days later, the patient underwent repeat operation due to the persistence of trophoblastic tissue within the fallopian tube. A review of the English literature reveals nine cases including our own that have been reported to date. In eight of nine cases, trophoblastic tissue was recovered at the time of the second operation. In the four cases where human chorionic gonadotropin (hCG) titers were available before and after the second procedure, the titers were positive initially and reverted to negative postoperatively. The disappearance curve for human chorionic gonadotropin after excision of an ectopic gestation is discussed. A recommendation is made for a single determination of beta-hCG two weeks after a conservative procedure for an ectopic gestation to screen for persistence of trophoblastic tissue.