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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.


Suk Woo Lee, Hyun Joo Choi, Yoon Kyung Lee, Joo Hee Yoon. Omental implantation secondary to ruptured tubal pregnancy with a negative urine pregnancy test: a case report. The Journal of reproductive medicine. 2013 Jan-Feb;58(1-2):89-92

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PMID: 23447928

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