Laparoscopic management of a primary omental pregnancy after clomiphene induction.

OBJECTIVE

To describe the successful laparoscopic management of a primary omental pregnancy.

DESIGN

Case report.

SETTING

Department of Obstetrics and Gynecology, Dr. Sami Ulus Obstetrics, Gynecology and Children's Hospital, Ankara, Turkey.

PATIENT(S): A 22-year-old patient with an omental pregnancy.

INTERVENTION(S): Laparoscopic partial omentectomy.

MAIN OUTCOME MEASURE(S): Successful laparoscopic management of an omental pregnancy.

RESULT(S): A 22-year-old woman presented to the emergency room with abdominal pain and vaginal spotting. She was undergoing clomiphene (CC) induction for infertility and had a positive urine pregnancy test at home. A right adnexal ectopic pregnancy was reported by ultrasonography. Due to increasing pain, laparoscopy was performed. The uterus and fallopian tubes appeared normal without any signs of pregnancy. A well-vascularized intact omental gestational sac was discovered in the right adnexal region in close proximity to the right ovary. By laparoscopy, the sac was resected with partial omentectomy. A primary omental pregnancy was confirmed by beta-hCG-positive trophoblast cells among omental fat cells.

CONCLUSION(S): Omental pregnancy is rather difficult to identify due to localization. When in close proximity to the adnexal region, it may mimic a tubal ectopic pregnancy. Laparoscopy offers a minimally invasive method for diagnosis and therapy.