Ectopic pregnancy and laparoscopy: review of 1197 patients treated by salpingectomy or salpingotomy

Ron Maymon, Adrian Shulman, Reuvit Halperin, Amir Michell, Ian Bukovsky

Research output: Contribution to journalReview articlepeer-review

Abstract

The past few decades have witnessed such a rapid rise in the incidence of ectopic pregnancy that it verges on the point of an 'epidemic disease'. Its early detection, with the aid of serum β-hCG, high resolution ultrasound and the more liberal use of laparoscopy, has dramatically altered the clinical presentation of this disease and permits the use of more conservative methods of management directed towards preserving fertility and reducing morbidity. In this review of 1197 patients, compiled from the English literature, various conservative or tubectomy operative laparoscopic procedures have been employed, with 93% and 98% respectively, being able to avoid further surgery. Among the group treated by the conservative approach, a 6% post-operative complication rate was reported, of which 4% were persistent ectopic, 48% intra-uterine, and 18% repeated ectopic pregnancies. Among the radically treated patients, 2 intra- and 1 post-operative complications necessitated laparotomies. The fertility work-up and performance outcome are less obvious among this group. The benefits, safety and efficacy of each of the laparoscopic options, with appropriate recommendations for their use, are discussed. However, despite the aforementioned dramatic progress, women with previous ectopic pregnancies still have reduced fertility potential. Preventive measures aimed at reducing its overall occurrence therefore seem to be the major factor towards preserving a patient's future fertility potential.

Original languageEnglish
Pages (from-to)61-67
Number of pages7
JournalEuropean Journal of Obstetrics, Gynecology and Reproductive Biology
Volume62
Issue number1
DOIs
StatePublished - Sep 1995

Keywords

  • Operative laparoscopy
  • Tubal pregnancy

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