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Review of the Management of Ectopic Pregnancy in a Major Teaching Hospital: Laparoscopic Surgical Treatment and Persistent Ectopic Pregnancy
Author(s) -
Parker Jim,
Permezel Michael,
Thompson Derrick
Publication year - 1994
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1994.tb01115.x
Subject(s) - salpingostomy , ectopic pregnancy , medicine , salpingectomy , laparotomy , laparoscopy , laparoscopic surgery , surgery , obstetrics , hydrosalpinx , pregnancy , gynecology , infertility , genetics , biology
Summary: Two hundred and three cases of ectopic pregnancy were examined to determine the current management trends at the Royal Women's Hospital during a period where laparoscopic and conservative therapies were being increasingly used. Only 25% of patients were managed by the previous method of laparotomy and salpingectomy. Ten (8.8%) of 114 cases treated by laparoscopic procedures had persistent trophoblast activity and 8 of these required further surgical or medical treatment. Seven (14.9%) of 47 cases treated by laparoscopic salpingostomy resulted in persistent ectopic pregnancy (PEP). The postoperative beta HCG profiles of 41 patients were examined to identify differences between the ‘persistent ectopic’ and ‘resolved ectopic’ groups. Postoperative serum beta HCG monitoring should be performed at day 4 and day 7 to enable the early detection of treatment failure. The risk of developing a PEP after laparoscopic salpingostomy was significantly increased (p <0.01) if the preoperative serum beta HCG was greater than 3,000 IU/L. A laparoscopic salpingectomy should be performed in cases where the preoperative beta HCG is above 3,000 IU/L and the contralateral tube appears normal.