Pj. Hajenius et al., CLEARANCE CURVES OF SERUM HUMAN CHORIONIC-GONADOTROPIN FOR THE DIAGNOSIS OF PERSISTENT TROPHOBLAST, Human reproduction, 10(3), 1995, pp. 683-687
A well recognized hazard of conservative surgical treatment of tubal p
regnancy is incomplete removal of trophoblastic tissue, Persistent tro
phoblast can be detected by postoperative serum human chorionic gonado
trophin (HCG) monitoring, The impact of various surgical techniques on
the post-operative clearance of serum HCG was investigated in a retro
spective study, The medical records of 97 patients treated surgically
for tubal pregnancy in the Academic Medical Center of the University o
f Amsterdam, The Netherlands, between 1 January 1992 and 1 August 1994
were reviewed; 28 patients were treated by salpingostomy by laparosco
py, 16 by salpingostomy by open surgery and 53 by salpingectomy by eit
her method, There was no difference in the post-operative clearance of
serum HCG after successful conservative surgery compared to radical s
urgery, However, persistent trophoblast occurred in eight patients (29
%) after laparoscopic salpingostomy and in only one patient (6.3%) who
had a salpingostomy by open surgery (relative risk 4.57), Serum HCG c
learance curves allow early identification of patients with persistent
trophoblast after conservative surgical treatment. Moreover, monitori
ng of post-operative serum HCG until it becomes undetectable is mandat
ory in order to reveal late-onset types of persistent trophoblast.