title: Omental implantation secondary to ruptured tubal pregnancy with a negative urine pregnancy test: a case report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Obstetrics and Gynecology, The Catholic University of Medicine of Korea, Seoul.
authors: Suk Woo
authors: SW
authors: Lee
authors: Hyun Joo
authors: HJ
authors: Choi
authors: Yoon Kyung
authors: YK
authors: Lee
authors: Joo Hee
authors: JH
authors: Yoon
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000652:urine*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery / Q000652:urine*; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000652:urine; D012422:Rupture, Spontaneous / Q000150:complications / Q000175:diagnosis
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human