Assessment of tubal disorder as a risk factor for repeat ectopic pregnancy after laparoscopic surgery for tubal pregnancy.
HEADING AIMS: We evaluated tubal disorders, including peritubal adhesions, as risk factors for repeat ectopic pregnancy (REP) after laparoscopic linear salpingotomy (LS) or salpingectomy for tubal pregnancy.


METHODS
This was a retrospective clinical study in a university hospital.


RESULTS
Of 43 women monitored for at least 6 months after LS, 28 (65%) subsequently conceived. In 24 (86%) of these women the pregnancy was intrauterine, and four (14%) had REP. Of 40 women with a unilateral tube monitored for at least 6 months after salpingectomy, 24 (60%) conceived. In 17 (71%) of these women the pregnancy was intrauterine, and seven (29%) had REP. There was no significant difference between groups in postoperative pregnancy or REP rates. There was no significant difference in the mean adhesion score by revised American Fertility Society stage points (re-AFS) at operation and the site of subsequent pregnancy in either the LS or the salpingectomy group, although the mean re-AFS score was significantly higher in women who had REP (3.1) than in those whose subsequent pregnancy was intrauterine (0.4).


CONCLUSIONS
There was no significant difference in postoperative pregnancy or REP rates following previous LS or salpingectomy. The re-AFS score appeared to be an accurate predictor of the prognosis of subsequent pregnancies.
Kuroda
Keiji
K
Department of Obstetrics and Gynaecology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan. arthur@juntendo.ac.jp
Takeuchi
Hiroyuki
H
Kitade
Mari
M
Kikuchi
Iwaho
I
Shimanuki
Hiroto
H
Kumakiri
Jun
J
Kobayashi
Yuko
Y
Kuroda
Masako
M
Takeda
Satoru
S
D000328:Adult; D005184:Fallopian Tube Diseases / Q000150:complications*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology*; D011274:Pregnancy, Tubal / Q000453:epidemiology / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D000267:Tissue Adhesions / Q000150:complications / Q000453:epidemiology