Laparoscopic management of a primary omental pregnancy after clomiphene induction

Sertac Esin, Sertaç Esin, Hilmi Yildirim, Hilmi Yıldırım, Fikret Tanzer
Fertility and sterility · 2009 · vol. 92(1) , pp. 392.e1–392.e3 · doi:10.1016/j.fertnstert.2009.02.026 · PMID:19327765 · W2072717082
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This case report describes the successful laparoscopic management of a primary omental pregnancy in a 22-year-old woman, highlighting that such ectopic pregnancies may mimic adnexal masses and are effectively treated via minimally invasive surgery.

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Abstract

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.

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MeSH descriptors

Abortion, Induced Clomiphene Estrogen Antagonists Omentum Pregnancy, Ectopic Chorionic Gonadotropin Chorionic Gonadotropin Clomiphene Estrogen Antagonists Female Humans Laparoscopy Omentum Omentum Pregnancy Pregnancy, Ectopic Pregnancy, Ectopic Pregnancy, Ectopic Ultrasonography Young Adult

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