Is Operative Laparoscopy Contraindicated in Women with Ectopic Pregnancy and Hypovolemic Shock?
We evaluated the safety of operative laparoscopy for the management of ectopic pregnancy in 119 women with hypovolemic shock. In 19 (16.0%) of these women hypovolemic shock was based on a combination of signs and symptoms including hypotension, tachycardia, anxiety, thirst, tachypnea, and slow capillary refill. The table below presents the results (mean &plusmn; SEM; ap <0.01). One case in each group was converted to laparotomy, and all patients made full recovery. Laparoscopy allows rapid diagnosis and control of the source of bleeding, making it highly suitable for the surgical management of a ruptured ectopic pregnancy. The availability of appropriate anesthesia and advanced cardiovascular monitoring, and ability to convert rapidly to a laparotomy if necessary, allow safe performance of operative laparoscopic surgery in women with hypovolemic shock.
Soriano
D
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer 52621 Israel.
Yefet
Y
Oelsner
G
Goldenberg
M
Mashiach
S
Seidman
DS