• Suk Woo Lee, Hyun Joo Choi, Yoon Kyung Lee, and Joo Hee Yoon.
• Department of Obstetrics and Gynecology, The Catholic University of Medicine of Korea, Seoul.
• J Reprod Med. 2013 Jan 1; 58 (1-2): 89-92.

BackgroundThe 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.CaseThis 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.ConclusionFor 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.

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