Laparoscopic prostaglandin injection in ectopic pregnancy: success rates according to endocrine activity.
OBJECTIVE
To investigate the clinical performance of local prostaglandin treatment of ectopic pregnancies (EPs) in relation to their biologic activity as determined by preoperative serum hCG levels.


METHODS
Prospective study over a 2-year period of 108 patients with 127 tubal pregnancies.


METHODS
A department of obstetrics and gynecology in a central county hospital.


METHODS
One hundred eight patients who presented with a clinical diagnosis of EP.


METHODS
Patients with EP were treated with laparoscopy-guided injection of prostaglandin F2 alpha in the surrounding tubal wall and the corpus luteum-bearing ovary. All members of the staff participated.


METHODS
Success rate, hospitalization cost, and convalescence period.


RESULTS
Seven laparotomies (7.5%) were performed postoperatively due to increasing hCG levels or ruptures with circulatory reactions. All except one had an initial (preoperative) hCG value > 1,000 mIU/mL (conversion factor to SI unit, 1.00). The mean hospitalization period was 2.7 days and 90% of the medically treated patients returned home on the first postoperative day. The mean convalescence period was 18 days.


CONCLUSIONS
The procedure is simple and carries an acceptable success rate in cases with hCG levels < 1,000 mIU/mL. The approach demands minimal technical resources and it may reduce health care costs substantially.
Central Hospital, County of Skaraborg, Skövde, Sweden.
G
G
Paulsson
S
S
Kvint
B M
BM
Labecker
T
T
Löfstrand
B
B
Lindblom
D000028:Abortion, Induced; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood; D015237:Dinoprost / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections; D010535:Laparoscopy / Q000379:methods; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis; D011446:Prospective Studies
D015415:Biomarkers; D006063:Chorionic Gonadotropin; D015237:Dinoprost