Predicting Success of Laparoscopic Salpingostomy for Ectopic Pregnancy

Rabischong, B.; Larraín, Demetrio; Pouly, Jean-Luc; Jaffeux, P.; Aublet-Cuvelier, Bruno; Fernandez, H.

doi:10.1097/aog.0b013e3181eeb80f

Cited by 26 publications

(22 citation statements)

References 35 publications

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“…In the PEP group, the median duration from the patient presenting with lower abdominal pain to undergoing surgery was 5.16 days (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Eight women presented with slight pain, 44 with obvious pain and 12 with rectal tenesmus.…”

Section: Resultsmentioning

confidence: 99%

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Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy

Zhang

Chen

et al. 2017

J of Obstet and Gynaecol

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AimThe aim of this study was to assay the clinical characteristics of persistent ectopic pregnancy (PEP) and its influence on ongoing pregnancy.MethodsWe retrospectively reviewed 2498 patients who received salpingostomies as primary management for ectopic pregnancies from January 2004 to December 2009, using medical records and telephone inquiries. Clinical characteristics of the 52 patients (2.08%) who were diagnosed with PEP after salpingostomy were compared with those who received satisfactory treatment. The odds ratios and 95% confidential intervals were calculated for each variable by univariate and (for significantly different factors) multivariate analysis.ResultsPreoperatively, patients with PEP after salpingostomy significantly differed from the non‐PEP patients in gestational age, mass size and pelvic adhesiolysis. Serum β‐human chorionic gonadotropin levels in PEP patients were monitored after surgery, which had declined by 28.31% on postoperative day (POD) 4, 40.22% on POD 7, 51.46% on POD 10 and 53.43% on POD 21. Repeat ectopic pregnancy (REP) tended to occur more frequently in PEP patients (PEP: 5 cases, 10.20%; non‐PEP: 4 cases, 2.80%; P = 0.034). Multivariate analysis showed that pelvic adhesions and PEP were the strongest independent predictors of REP.ConclusionGestational age, mass size and pelvic adhesions were significantly correlated with PEP. PEP was an independent prognostic factor for REP. However, a multicenter study is needed to support and extend our findings.

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Section: Resultsmentioning

confidence: 99%

“…Rabischong et al . determined that a hCG level ≥ 1960 IU/L was the only risk factor related to treatment failure . Tews et al .…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy

Zhang

Chen

et al. 2017

J of Obstet and Gynaecol

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“…Dans une approche conservatrice, les taux d'échec varient selon qu'il s'agit d'un traitement médical par méthotrexate ou chirurgical par coelioscopie. Les résul-tats récents du registre d'Auvergne [30,31] ont en effet montré respectivement un taux d'échec moyen de 6,6 % pour la salpingotomie [30] et de 24,6 % après une injection de méthotrexate avec dans ce cas un risque significativement augmenté (16,5 vs 40 %) si le taux de ␤HCG initial est supérieur à 1300 UI [31].…”

Section: Discussionunclassified

Facteurs de risque de récidive des grossesses extra-utérines

Bennetot

Rabischong

Aublet-Cuvelier

et al. 2012

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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“…La salpingotomie était réalisée avec la pointe des ciseaux monopolaires fermés. Certains auteurs pensent que l'utilisation de la pointe monopolaire est préférable étant donné que la surface délivrant l'énergie est minime et diminue le traumatisme tissulaire [14]. Ce traumatisme moindre serait surtout corrélé au pronostic obstétrical plutôt qu'au risque de persistance de trophoblaste.…”

Section: Discussionunclassified

“…Il est probable que le diamètre de la canule d'aspiration influence probablement le risque de persistance de trophoblaste. L'utilisation d'une canule de 10 mm semble diminuer ce risque [14].…”

Section: Discussionunclassified