Ectopic Pregnancy
Conditions
Brief summary
Traditionally, salpingectomy has been the standard procedure for managing ectopic pregnancy. We would like to evaluate the safety and efficacy of laparoscopic tubal preservation surgery in treating ectopic pregnancies (salpingostomy or salpingotomy) while preserving the fertility outcome of the patients, as well as to identify the factors predicting the presence of persistent ectopic pregnancy after the surgery.
Detailed description
All surgically-treated ectopic pregnancies in women aged 20 and above between 01 January 2009 and 31 December 2016 were identified. Cases receiving laparoscopic salpingostomy or laparoscopic salpingotomy were extracted from the database, patient characteristics and surgical outcomes (changes of serumβ-hcg, presence of persistent ectopic pregnancy and subsequent management, subsequent pregnancy) were reviewed from their medical records. Univariate and multivariate logistic regression analysis were employed to predict the presence of persistent ectopic pregnancy after laparoscopic tubal preservation surgery.
Interventions
PROCEDURElaparoscopic salpingotomy or salpingostomy
A 3-port technique (2 x 5-mm and 1 x 10-mm trocars) was implemented. A diluted solution of vasopressin (20IU in 100 mL saline solution) was initially injected into the mesosalpinx of the affected tube, followed by a linear incision which allowed the removal of the gestational tissue. In case of a ruptured tubal pregnancy, the ectopic mass was evacuated directly from the ruptured site using a combination of forceps and suction device. The tubal lumen was either closed with a single-layer of continuous absorbable suture (salpingotomy) or left to heal by secondary intention (salpingostomy).
Sponsors
Far Eastern Memorial Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* women who had laparoscopic tubal preservation surgery (including salpingostomy and salpingotomy) for ectopic pregnancy between January 2009 and November 2016
Exclusion criteria
* women with ectopic pregnancy at sites other than fallopian tube (i.e. interstitial, ovary, abdomen)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| peri- and post-operative parameters | between January 2009 and November 2016 | success rate of tubal preservation surgery (defined by postoperative serum bcg \<5 IU/mL), postoperative complications (number of women who had adverse surgical outcome such as bladder injury, bowel injury, massive bleeding), pregnancy outcome (number of women who conceived successfully following the intervention) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| factors affecting the surgical success rate | between January 2009 and November 2016 | relationship between patient's baseline characteristics and rate of persistent ectopic pregnancy (unvariate and multivariate analysis) |
Countries
Taiwan
Outcome results
None listed