Salpingostomy for ectopic pregnancy in the sole patent oviduct: reproductive outcome.

The ultimate success of conservative surgery for tubal ectopic pregnancy is difficult to evaluate in the presence of a potentially normal contralateral fallopian tube. Fifteen cases of tubal pregnancy with only one functional fallopian tube were treated by linear salpingostomy at Yale-New Haven Hospital between 1975 and 1980. The overall term viable pregnancy rate to date is 53%; the recurrent ectopic pregnancy rate is 20%. Twenty-seven percent of those patients operated upon until now have not conceived. These statistics are based on a 100% follow-up of at least 1 year, with all patients trying actively to conceive. Review of the literature on conservative treatment of ectopic pregnancy when only one tube is present reveals an intrauterine pregnancy rate of 61% and a repeat ectopic pregnancy rate of 17%. We conclude that linear salpingostomy is an acceptable surgical technique for the treatment of tubal ectopic pregnancy, because this experiment, by its nature, eliminates the variable performance of the contralateral tube in relationship to subsequent intrauterine pregnancy and repeat ectopic pregnancy in these patients.