Reproductive outcomes of ectopic pregnancy with conservative and surgical treatment: A systematic review and meta-analysis

Hao, Hong-Juan; Li, Feng; Dong, Li-Fei; Zhang, Wei; Zhao, Xiaoli

doi:10.1097/md.0000000000033621

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…Similarly, in a retrospective cohort of 30,450 PID patients and 91,350 controls, Huang et al found that PID patients had a 2.121-fold (p = 0.003) higher risk of developing an ectopic pregnancy in Taiwan region [10]. All these results are supported by Xia et al who explored the relationship between chlamydia trachomatis infections and ectopic pregnancy in a recent meta-analysis and systematic review, and found that the association between chlamydia trachomatis infections and the risk of EP showed an odds ratio (OR) of 3.03, with a 95% confidence interval (CI) of 2.37 to 3.89 [11]. Our result is therefore in line with numerous studies that have identified PID as a major risk factor for EP, due to scarring leading to tubal obstruction that interferes with egg capture and migration.…”

Section: Discussionmentioning

confidence: 62%

Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

Cyrille,

Hilary,

Robert

et al. 2024

OJOG

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Background: Ectopic pregnancy is a major cause of maternal morbidity and mortality, estimated to occur in 1% -2% of pregnancies worldwide. This condition also has an adverse effect on the fertility prospects of women who experience it. Objective: To determine the outcomes of subsequent spontaneous fertility after medical treatment of patients with methotrexate (MTX) in patients with ectopic pregnancy at two university teaching hospitals of Yaounde. Methodology: We carried out a cross-sectional study with retrospective data collection in two university teaching hospitals of Yaounde during a six years period from 1 st January 2015 to 31 st May 2021. Seventy records of patients who had medical treatment for ectopic pregnancy were included in this study. Statistical analysis was performed using SPSS. 23. The Chi-2 statistical test was used to compare qualitative variables. Binary logistic regression method was performed to identify independent risk factors associated with infertility after medical treatment of tubal ectopic pregnancy (TEP). The significance level was set at 0.05. Results: The mean age in our study population was 27.8 ± 3.8 years. According to the past medical history, 52.9% had a pelvic inflammatory disease (PID) and the most frequently germ found was C. trachomatis (47.1%). Almost 15% of our study population had previous surgery for EP. The median Fernandez score was 11 with a minimum score of 4 and a maximum score of 13. The route of administration of methotrexate was intramuscular in all our patients, and the single-dose protocol was used most frequently (58.6%). After medical treatment of the EP, we found a spontaneous conception rate of 58.6%. After multivariate analysis, we were unable to confirm that there was an association between a history of sexually transmitted infections (STIs) and fertility prognosis. Conclusion: The spontaneous fertility rate after medical management of EP was 58.6%, of which 73.

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Section: Discussionmentioning

confidence: 62%

Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

Cyrille,

Hilary,

Robert

et al. 2024

OJOG

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“…Hao et al showed that there was no significant difference in the odds of subsequent intrauterine pregnancy and repeat ectopic pregnancy following treatment with MTX compared to salpingostomy. [8] However, no studies have shown the effect of tubal patency on a second pregnancy. The condition of the fallopian tube after tubal pregnancy treatment, whether it is unobstructed or not, has a significant impact on future pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of tubal pregnancy with tubal preservation: A meta-analysis

Long,

Lin,

et al. 2023

Medicine

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Background: Ectopic pregnancy is a common gynecological emergency that poses a significant risk of maternal mortality during the first trimester. It also increases the incidence of infertility and repeated ectopic pregnancy. The aim of this study was to evaluate whether there is a difference in the degree of tubal patency between salpingostomy and systemic treatment with methotrexate (MTX), as well as the odds of intrauterine pregnancy and repeat ectopic pregnancy, and the degree of tubal patency in salpingectomy with or without tubal suturing. Methods: We searched PubMed, EMBASE, and the Cochrane Library up to April 2023. Four randomized controlled trials were included in the review. We analyzed the combined data using Review Manager 5.3 software and Stata 12.0 software, utilizing a random effects model. Results: When comparing salpingostomy and systemic treatment with MTX, there was no significant difference in the degree of tubal patency (OR = 1.09, 95% CI (0.54–2.38), P = .83). For salpingostomy with or without tubal suturing, there were no significant differences in the rates of intrauterine pregnancy, repeat ectopic pregnancy, and tubal patency degree [(OR = 1.05, 95% CI (0.41–2.68), P = .92), (OR = 0.68, 95% CI (0.19–2.42), P = .92), (OR = 1.68, 95% CI (0.14–20.33), P = .68)]. Conclusion: This meta-analysis demonstrates that systemic treatment with MTX is an effective treatment for patients who wish to preserve their fallopian tubes without undergoing surgery. This form of treatment can help avoid surgical procedures that may damage the fallopian tubes and improve fertility prospects. If choosing surgery, we believe that opting for salpingostomy without tubal suturing could reduce the operation time and minimize damage.

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Comparison of 2-year reproductive outcomes of tubal ectopic pregnancies treated with surgery, methotrexate or expectant management

Fıratlıgil,

Sucu,

Sucu

et al. 2024

Arch Gynecol Obstet

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Reproductive outcomes of ectopic pregnancy with conservative and surgical treatment: A systematic review and meta-analysis

Cited by 3 publications

References 27 publications

Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

Treatment outcomes of tubal pregnancy with tubal preservation: A meta-analysis

Comparison of 2-year reproductive outcomes of tubal ectopic pregnancies treated with surgery, methotrexate or expectant management

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