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Tubal patency after laparoscopic treatment of ectopic pregnancy
N Colacurci1, R Zarcone, P de Franciscis
12nd Department of Gynecology and Obstetrics, School of Medicine, Second University of Naples, Italy.
Objective:
To evaluate operative course, tubal patency and reproductive performance after laparoscopic treatment of ectopic pregnancy in relation to initial human chorionic gonadotropin (hCG) values and to the kind of operation.
Design:
Retrospective study.
Patients:
Fourty-five patients affected by ectopic pregnancies: thirty-two treated with laparoscopic linear salpingotomy subvided into two groups depending on the hCG serum values < 10,000 mUl/ml (twenty patients: group 1) or > 10,000 mUl/ml (twelve patients Group 2), thirteen patients (Group 3) undergoing laparoscopic salpingectomy. Hysterosalpingographic examination was performed two or three months after surgery.
Main Outcome Measures:
Operative time, major surgical complications, tubal patency and pregnancy rate after surgery.
Results:
Operative time was significantly (p < 0.05) lower in both group 1 and 3 (22.5 +/- 3.2 and 19.1 +/- 6.3, respectively) than in group 2 (39.4 +/- 5.6). Bilateral patent tubes were observed in eighteen cases of group 1 (90%) and eight cases of group 2 (60%). No statistically significant differences were found between the pregnancy rate of both group 1 (8/18) and 2 (3/8) and of group 3 (3/11).
Conclusions:
Reproductive outcome is similar in both conservative and destructive laparoscopic management of ectopic pregnancy: furthermore it shows a trend of improvement, not statistically significant, in conservative treatment.