Operative laparoscopy for management of ectopic pregnancy in patients with hypovolemic shock

David Soriano, Yuval Yefet, Gabriel Oelsner, Mordechai Goldenberg, Shlomo Mashiach, Daniel S. Seidman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Study Objective. To determine the safety of operative laparoscopy in the management of ectopic pregnancy in women with hypovolemic shock. Design. Retrospective chart review. Setting. University-affiliated hospital. Patients. Two hundred eleven women with tuba I pregnancy, of whom 33 were suffering from hypovolemic shock, based on a combination of signs and symptoms including hypotension, tachycardia, anxiety, thirst, tachypnea, and slow capillary refill. Intervention. Laparoscopic surgery. Measurements and Main Results. Mean ± SEM intraabdominal blood loss was significantly (p <0.01) higher in women with hypovolemic shock, 1369 ± 149 versus 114 ± 14 ml. Blood transfusions were given to 88% and 0.5%, respectively (p <0.01). Laparoscopic salpingectomy was performed in all hemodynamically compromised women compared with 87% of stable women. Conversion to laparotomy was required in three patients in the hypovolemic shock group and five in the stable group. All patients had an uncomplicated postoperative course and made a full recovery. Conclusion. The availability of optimal anesthesia and advanced cardiovascular monitoring, and the ability to convert rapidly to laparotomy if required, allow safe performance of operative laparoscopic surgery in most women in hypovolemic shock. In fact, the superior exposure of laparoscopy, providing rapid diagnosis and control of the source of bleeding, makes it a highly suitable approach.

Original languageEnglish
Pages (from-to)363-367
Number of pages5
JournalJournal of the American Association of Gynecologic Laparoscopists
Issue number3
StatePublished - May 1997
Externally publishedYes


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