Tubal patency after laparoscopic treatment of ectopic pregnancy.

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.