TheAnswerPage/Obstetrics & Gynecology Friday 09/03/2010 This week: Ectopic pregnancy

We continue our discussion of ectopic pregnancy. A 20-year-old G₁P₀Ectopic₁ is seeing you for a second opinion. Her primary obstetric care provider performed a laparoscopic salpingostomy for a tubal ectopic pregnancy a few weeks ago. The pathology confirmed chorionic villi. She did not have any follow-up blood tests or office visits until almost one month later when she developed some spotting. Her β-hCG level is now 220 mIU/mL. Her doctor has told her that she likely has a molar pregnancy.

1. What it the most likely diagnosis in this patient?
2. How could this problem have been detected sooner?
3. What are this patient's treatment options?
4. What is the main advantage of not removing the oviduct at the time of surgery for an unruptured tubal pregnancy?

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