Comparison of persistent ectopic pregnancy after laparoscopic salpingostomy versus salpingostomy at laparotomy for ectopic pregnancy.
OBJECTIVE
To compare persistent ectopic pregnancy after laparoscopic salpingostomy versus salpingostomy at laparotomy for the treatment of intact ampullary ectopic pregnancy.


METHODS
We reviewed the medical records of 157 patients who had undergone salpingostomy for intact ampullary ectopic pregnancy at Yale-New Haven Hospital between September 1, 1986 and August 31, 1991. One hundred three women had laparoscopic salpingostomy and 54 had salpingostomy at laparotomy.


RESULTS
Sixteen of 103 women (15.5%) undergoing laparoscopic salpingostomy were treated for persistent ectopic pregnancy, in contrast to one of 54 women (1.8%) who had salpingostomy by laparotomy. The adjusted odds ratio for persistent ectopic pregnancy after laparoscopic salpingostomy versus salpingostomy at laparotomy for an intact ampullary ectopic pregnancy was 8.4, with 95% confidence interval 1.1-62 (P < .02). Stepwise logistic regression demonstrated that a laparoscopic approach to salpingostomy (P < .05), smaller ectopic size (P < .01), and fewer days of amenorrhea (P < .05) predicted persistent ectopic pregnancy.


CONCLUSIONS
Persistent ectopic pregnancy is more likely after laparoscopic salpingostomy than after salpingostomy at laparotomy for intact ampullary ectopic pregnancy.
Seifer
D B
DB
Division of Reproductive Endocrinology, Women and Infants Hospital, Brown University School of Medicine, Providence, Rhode Island.
Gutmann
J N
JN
Grant
W D
WD
Kamps
C A
CA
DeCherney
A H
AH
D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D007813:Laparotomy; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000453:epidemiology / Q000601:surgery*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012489:Salpingostomy