Laparoscopic instillation of hyperosmolar glucose vs. expectant management of tubal pregnancies with serum hCG < or = 2500 mIU/mL.
OBJECTIVE
To compare expectant management with local instillation of 50% glucose solution for tubal pregnancies with a serum hCG level < or = 2500 mIU/mL.


METHODS
Prospective, non-randomized, comparative clinical study.


METHODS
Two university departments.


METHODS
One hundred and twenty-eight patients with laparoscopically-confirmed tubal pregnancy and serum hCG < or = 2500 mIU/mL.


METHODS
Eighty patients in Graz were treated with laparoscopic instillation of 50% glucose solution and 48 patients in Turku were followed expectantly.


METHODS
Resolution of hCG excretion, need for further interventions.


RESULTS
Seventy-four of the 80 patients (92%) in the glucose group (32 of 33 with an initial hCG < or = 250 mIU/mL and 42 of 47 with hCG 251-2500 mIU/mL) and 36 of 48 (75%) patients in the expectant group (19 of 23 with an initial hCG < or = 250 mIU/mL and 17 of 25 with hCG 251-2500 mIU/mL) had resolution of the pregnancy with no further intervention (p=0.008, chi-square test, odds ratio 0.24).


CONCLUSIONS
Glucose instillation is superior to expectant management for patients with early tubal pregnancy.
Lang
P F
PF
Department of Obstetrics and Gynecology, University of Graz, Austria.
Mäkinen
J I
JI
Irjala
K M
KM
Rantala
M
M
Hönigl
W
W
Tamussino
K
K
Haas
J
J
D000328:Adult; D001317:Austria; D006063:Chorionic Gonadotropin / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005387:Finland; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D009994:Osmolar Concentration; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal
D006063:Chorionic Gonadotropin; D005947:Glucose