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Published on: July 25, 2017
Elevated maternal serum alpha-fetoprotein associated with an asymptomatic tubal pregnancy at 20 weeks' gestation
K E Grullon1, V A Feldstein, K H Lim
1Department of Obstetrics, University of California, San Francisco, USA. ken@ob.ucsf.edu
Background:
Most tubal ectopic pregnancies become symptomatic in the first trimester and rarely progress to the second trimester. Elevated maternal serum alpha-fetoprotein (MSAFP) has rarely been associated with second-trimester tubal pregnancy. We present a case of a 20-week asymptomatic tubal pregnancy identified by elevated MSAFP.
Case:
An asymptomatic 22-year-old woman at 20 weeks' gestation was evaluated with a targeted fetal survey for an abnormally elevated MSAFP. The ultrasound examination revealed an extrauterine gestation. The patient was taken to exploratory laparotomy, and a total salpingectomy was performed.
Conclusion:
Although rare, a second-trimester ectopic pregnancy must be considered in the differential diagnosis of elevated MSAFP. A careful ultrasound scan should rule out an extrauterine pregnancy.
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