CONSERVATIVE SURGICAL MANAGEMENT OF UNRUPTURED ECTOPIC PREGNANCY

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  • 1 January 1979
    • journal article
    • research article
    • Vol. 54  (4) , 451-455
Abstract
With the earlier and more accurate diagnosis of ectopic pregnancy based on rapid .beta.-subunit pregnancy tests and the use of ultrasound and laparoscopy, the percentage of diagnosed unruptured ectopic pregnancies is rapidly increasing. This, coupled with the earlier treatment of pelvic inflammatory disease, the use of intrauterine devices and increasing numbers of tubal plastic surgery, caused the problem of conservative management of ectopic pregnancy to be evaluated. Patients [98] at the Yale-New Haven Hospital who had ectopic pregnancies from 1972-1977 were evaluated. Of these patients, [98] underwent a salpingectomy or salpingo-oophorectomy. Patients [48] underwent salpingostomy. This represents an increase in the conservative surgery rate from 8-35.5%. The overall term viable pregnancy rate was 40%, along with a 10% repeat ectopic rate. There was no advantage as far as term viable pregnancy when comparing salpingostomy and salpingectomy. Conservative surgery did not increase the repeat ectopic rate. Salpingostomy is recommended in unruptured ampullar ectopic pregnancies to preserve reproductive function. If current trends continue, this will be an increasingly important problem. The statistics are based on a 73% follow-up, with all patients actively trying to conceive.

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