Lee Suk Woo, Choi Hyun Joo, Lee Yoon Kyung, Yoon Joo Hee
Department of Obstetrics and Gynecology, The Catholic University of Medicine of Korea, Seoul.
J Reprod Med. 2013 Jan-Feb;58(1-2):89-92.
The first steps in the diagnosis of an ectopic pregnancy are to use a sensitive qualitative urine test to detect the beta-subunit of human chorionic gonadotropin (beta-hCG) and to perform a transvaginal ultrasonograph. y negative urine pregnancy test result is generally used to exclude an ectopic pregnancy; however, a few studies have reported the presence of a ruptured ectopic pregnancy in a patient with a negative urine pregnancy test result. Furthermore, because secondary omental implantation (SOI) is rare and probably underestimated or misdiagnosed, a case of an SOI with a negative urine hCG test has never been reported.
This was a very rare case of an SOI from a ruptured tubal pregnancy in a patient with an initial series of negative urine pregnancy tests and decreased levels of serum beta-hCG. The SOI was managed with laparoscopy.
For patients diagnosed with tubal or ovarian pregnancy who have negative urine pregnancy test results and decreased levels of serum beta-hCG, late-onset omental implantation should be considered as a possibility.
诊断异位妊娠的首要步骤是使用灵敏的定性尿液检测来检测人绒毛膜促性腺激素的β亚基（β-hCG）并进行经阴道超声检查。尿液妊娠试验结果为阴性通常用于排除异位妊娠；然而，有一些研究报道了尿液妊娠试验结果为阴性的患者存在破裂的异位妊娠。此外，由于继发性网膜植入（SOI）罕见，可能被低估或误诊，从未有过尿液hCG检测呈阴性的SOI病例报告。
这是一例非常罕见的因输卵管妊娠破裂导致的SOI病例，患者最初尿液妊娠试验结果呈阴性，血清β-hCG水平下降。该SOI通过腹腔镜进行治疗。
对于诊断为输卵管或卵巢妊娠但尿液妊娠试验结果为阴性且血清β-hCG水平下降的患者，应考虑迟发性网膜植入的可能性。
