Factors Predicting Persistent Ectopic Pregnancy After Laparoscopic Salpingostomy or Salpingotomy for Tubal Pregnancy: A Retrospective Cohort Study

Ting, Wan-Hua; Lin, Ho‐Hsiung; Hsiao, Sheng‐Mou

doi:10.1016/j.jmig.2018.10.004

Cited by 7 publications

(3 citation statements)

References 21 publications

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“…To prevent this, it is important to remove all pathological tissue during surgery as well as clots, to decrease the possibility of leaving reimplantation tissue behind. The Trendelenburg position is recommended as well as the complementary administration of methotrexate [34].…”

Section: Abdominal Pregnancymentioning

confidence: 99%

Endoscopic Approach to Ectopic Pregnancy

Rosales-Ortíz¹,

T²,

Vázquez³

et al. 2022

Ectopic Pregnancy and Prenatal Diagnosis

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Minimally invasive surgery is an option in the management of ectopic pregnancy, it may be rupture, not rupture, or complement of medical treatment. In addition to the known advantages of endoscopic surgery in the field of obstetrics, it allows better conservative management of the fallopian tube and ovaries, allowing a better reproductive prognosis. The surgical technique to be performed of the clinical findings, the hemodynamic status, and the anatomical location of the ectopic pregnancy. Salpingectomy is performed in the ruptured ectopic pregnancy, assessing the integrity of the contralateral salpinge. Linear salpingostomy is performed on unbroken ectopic pregnancy preserving the fallopian tube, in the literature, this technique has reported maintenance of the fertility rate. In case of a cervical or niche ectopic pregnancy, resectoscopy is recommended.

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Section: Abdominal Pregnancymentioning

confidence: 99%

Endoscopic Approach to Ectopic Pregnancy

Rosales-Ortíz¹,

T²,

Vázquez³

et al. 2022

Ectopic Pregnancy and Prenatal Diagnosis

View full text Add to dashboard Cite

show abstract

“…Treatment of EP has different strategies, such as expectant management (following the β -human chorionic gonadotropin (β-hCG) until its return to the normal level), medical treatment (methotrexate), and surgery [ 14 , 15 ]. The management choice depends on the serum level of B-hCG, EP site, history of the previous EP, desire for a future pregnancy, and surgical skills [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the recurrence and fertility rate following salpingostomy in patients with tubal ectopic pregnancy

Poordast

Naghmehsanj

Vahdani

et al. 2022

BMC Pregnancy Childbirth

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Background Ectopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility. The objective of this study was to evaluate the recurrence and fertility rate after salpingostomy in patients with tubal ectopic pregnancy. Methods This cross-sectional retrospective study was conducted at four referral centers of Obstetrics and Gynecology, under the supervision of Shiraz University of Medical Sciences (Iran). The medical records of 125 patients with tubal pregnancy were reviewed. These patients underwent laparoscopic salpingostomy from April 2009 to March 2016.Data on maternal age, BMI, history of previous EP, genital tract infection, IUD insertion, history of previous surgery, and infertility were further obtained. The patients were followed up for approximately 1 to 7 years. The recurrence of EP and subsequent pregnancy rate were assessed during the follow-up period. Results There was no statistically significant relationship between post-salpingostomy recurrence and maternal age, previous abdominopelvic surgery, and history of infertility(P = .425); however, the post-salpingostomy recurrence of EP was correlated with BMI (P = 0.001), previous history of EP (P = 0.001), genital tract infection (P = 0.001), and IUD insertion (P = 003). Among 95 women who had no contraception, pregnancy occurred in 51 cases (53.6%) and recurrence of EP was observed in 16 patients (12.8%). Conclusions Our results suggest that salpingostomy is a safe method with a low risk of recurrence and good fertility outcomes for women who consider future pregnancy.

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“…Unfortunately, patients with salpingotomy can be at high risk of recurrent ectopic pregnancy (REP) and secondary infertility later on [ 6 ]. What’s more, there is an increased incidence of persistent ectopic pregnancy (PEP) [ 7 ] in these patients.…”

Section: Introductionmentioning

confidence: 99%

Preliminary hysteroscopic tubal hydrotubation improves fertility outcomes after laparoscopic salpingotomy for tubal ampullary pregnancy

Lin

Zhang

et al. 2022

BMC Surg

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Background Salpingotomy may change the anatomical structure and patency of the fallopian tube, which may affect the fallopian function. This study is to investigate the clinical efficacy of preliminary hysteroscopic tubal hydrotubation (HTH) after laparoscopic salpingotomy for tubal ampullary pregnancy. Methods A retrospective study was carried out, 140 women underwent laparoscopic salpingotomy for ampullary pregnancy from March 2013 to March 2017. Some patients received HTH in the 1st month and hysterosalpingography (HSG) in the 3rd month after salpingotomy (HTH group; n = 95), and some patients only received HSG in the 3rd month after salpingotomy (control group; n = 45). Clinical data, tubal patency and fertility outcome were evaluated after follow-up of 15 months. Results The tubal patency rate of the operated side was significantly higher in the HTH group than that in the control group (89.47% vs 68.89%, P < 0.05). The intrauterine pregnancy (IUP) rate was significantly higher in the HTH group (76.47% vs 51.11%, P < 0.05), and the recurrent ectopic pregnancy rate in the operated side was significantly lower in the HTH group than in the control group (9.41% vs 22.22%, P < 0.05). Logistic regression analysis showed that the positive factor for IUP was HTH (OR = 3.109, 95% CI 1.439–6.714, P = 0.004), while the negative factors were history of pelvic inflammatory disease (PID) (OR = 0.167, 95% CI 0.074–0.377, P < 0.001) and history of tubal infertility (OR = 0.286, 95% CI 0.113–0.723, P < 0.05). Conclusion Preliminary HTH after laparoscopic salpingotomy for ampullary pregnancy could improve reproductive function and lead to a better fertility outcome. Patients without history of PID or tubal infertility may be the most suitable ones for HTH after salpingotomy.

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Factors Predicting Persistent Ectopic Pregnancy After Laparoscopic Salpingostomy or Salpingotomy for Tubal Pregnancy: A Retrospective Cohort Study

Cited by 7 publications

References 21 publications

Endoscopic Approach to Ectopic Pregnancy

Endoscopic Approach to Ectopic Pregnancy

Evaluation of the recurrence and fertility rate following salpingostomy in patients with tubal ectopic pregnancy

Preliminary hysteroscopic tubal hydrotubation improves fertility outcomes after laparoscopic salpingotomy for tubal ampullary pregnancy

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