Reproductive outcome after 143 laparoscopic procedures for ectopic pregnancy.
OBJECTIVE
To analyze reproductive outcome after laparoscopic procedures for ectopic pregnancy, with particular attention to laparoscopic salpingectomy.


METHODS
In a 260-physician multispecialty clinic in the rural upper midwestern United States, 143 patients were followed prospectively after undergoing laparoscopic procedures for ectopic pregnancy. Ninety-five who sought further pregnancies during the study period were analyzed for reproductive outcome. Intrauterine pregnancy rates were compared by age, parity, size of ectopic gestation, and evidence of prior tubal damage. Life table analysis was also performed.


RESULTS
The overall intrauterine pregnancy rates for laparoscopic salpingostomy (60%) and laparoscopic salpingectomy (54%) were not significantly different from each other. However, intrauterine pregnancy rates differed significantly by history of prior tubal damage. The pregnancy rate was 79% among women without tubal damage and 42% among women with damage.


CONCLUSIONS
Our intrauterine pregnancy rates after both laparoscopic salpingectomy and laparoscopic salpingostomy are similar to those reported in the literature for similar procedures performed at laparotomy. In predicting pregnancy outcome after laparoscopic procedures for ectopic pregnancy, the major variable seemed to be evidence of prior tubal damage. With no evidence of previous damage, we found similarly high pregnancy rates for laparoscopic salpingostomy and salpingectomy.
Silva
P D
PD
Department of Obstetrics and Gynecology, Gundersen/Lutheran Medical Center, La Crosse, Wisconsin.
Schaper
A M
AM
Rooney
B
B
D000328:Adult; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D015993:Life Tables; D015146:Midwestern United States / Q000453:epidemiology; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011271:Pregnancy, Ectopic / Q000601:surgery*; D011446:Prospective Studies; D012489:Salpingostomy