[Recurrence after conservative celioscopic treatment of a first ectopic pregnancy]

Conservative laparoscopic treatment by salpingotomy was performed on 192 patients who presented with a first ectopic pregnancy (EP). The overall fertility results show that 139 patients (72.4%) obtained an Intra Uterine Pregnancy (IUP), whereas only 18 patients (9.4%) suffered a recurrence. The risk of ipsilateral recurrence is 66.7% (12 cases). For the 14 patients presented with two patent tubes after conservative laparoscopic treatment of a first EP, the ipsilateral recurrence rate is 57.1% (8 cases). The side of the recurrence is directly influenced by the patient's previous history. While 88.9% (8 cases) of recurrence are ipsilateral for patients presenting previous tubal history, this rate is only 44.4% (4 cases) when tubal factors are absent (p less than 0.05). This prompts us to recommend laparoscopic salpingectomy for patients with a serious past tubal history. In these patients recurrence is ipsilateral in more than three out of four cases. On the other hand, for patients with no or few tubal factors the treatment has to be conservative.