Conservative laparoscopic treatment of 321 ectopic pregnancies.
From 1974 to 1984, 321 tubal pregnancies were treated conservatively with laparoscopic techniques. Fifteen cases (4.8%) required a subsequent laparotomy or second laparoscopic procedure because of retained trophoblastic tissue. Of 118 patients desiring subsequent pregnancy, 76 had an intrauterine pregnancy (64.4%) and 26 had a second ectopic pregnancy (22%). Eleven of 24 (45.8%) women attempting conception following conservative laparoscopic removal of an ectopic gestation from the sole remaining fallopian tube established an intrauterine pregnancy. In this same group, seven patients (29.2%) had a second ectopic pregnancy. The fertility results were also analyzed according to the previous history. The postoperative intrauterine pregnancy rate was 85.5% among 62 patients without a history of infertility (group I), compared with 41.1% among 56 patients with a history of infertility or a previous ectopic pregnancy (group II). The subsequent ectopic pregnancy rate in group I was 16.1% versus 28.6% in group II. This large series clearly demonstrates the relative safety and efficacy of conservative laparoscopic treatment of tubal pregnancies.
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology; D010535:Laparoscopy; D007813:Laparotomy; D008722:Methods; D011183:Postoperative Complications; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors