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Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial
P Lundorff1, J Thorburn, B Lindblom
1Department of Obstetrics and Gynecology, University of Göteborg, Sweden.
Objective:
To evaluate the fertility outcome after laparoscopic surgery for ectopic pregnancy.
Design:
A randomized trial versus laparotomy was performed between May 1987 and June 1989.
Setting:
The study was conducted in a clinical university center, the Sahlgrens Hospital.
Patients:
A group of 105 patients with tubal pregnancy were stratified with regard to risk determinants and age and randomized to laparoscopy or laparotomy. Eighty-seven patients who desired pregnancy were evaluated for subsequent fertility outcome.
Interventions:
Linear salpingotomy was performed in both surgical groups.
Main Outcome Measure:
We evaluated the fertility outcome after laparoscopic salpingotomy for comparison with the outcome after laparotomy.
Results:
There was no difference between the groups in the overall fertility outcome. A substantially higher proportion of patients in the laparotomy group were subjected to adhesiolysis performed at a second-look laparoscopy.
Conclusions:
The fertility prospects are not impaired by laparoscopic surgery. Adhesiolysis at a second-look laparoscopy, especially after laparotomy, might be beneficial in selected cases and may serve to improve subsequent fertility.