title: Reduced prevalence of chronic tubal inflammation in tubal pregnancies after levonorgestrel emergency contraception failure.
abstract: OBJECTIVE
  The aim of this study was to compare chronic fallopian tubal inflammatory disease and fibrosis between patients with general tubal pregnancy (TP) and TP with levonorgestrel (LNG) emergency contraception (EC) failure.
  
  
  METHODS
  We retrospectively studied patients with general TP (n = 79) and TP following LNG-EC failure (n = 81) within the same conception cycle. Information on the gynecological features of each subject was collected. Pelvic inflammatory disease and associated sequelae were assessed by the serum Chlamydia trachomatis (CT) IgG test, laparoscopic evaluation of tubal damage, and histopathological observation of tube tissues. Chi-square and Student's t-tests were employed to determine the difference between the two groups.
  
  
  RESULTS
  Compared with general TP, cases of TP following LNG-EC failure subjects were less likely to have a history of previous ectopic pregnancy (5.06% vs. 18.52%, p = 0.009) and adnexal surgery (6.33% vs. 22.22%, p = 0.010). Patients with TP following LNG-EC failure were less likely to have pelvic inflammatory disease and associated sequelae than those with general TP, as revealed by positive reaction to anti-CT IgG (18.18% vs. 35.94%, p = 0.031), assessment of tubal damage (grade I: 5.06% vs. 17.28%; grade II: 2.53% vs. 11.11%; grade III: 1.27% vs. 6.17%; p = 0.001), infiltration of chronic inflammatory cells (10.91% vs. 62.50%, p < 0.001), and positive Masson's staining (7.69% vs. 39.58%; p < 0.001).
  
  
  CONCLUSIONS
  Compared with cases of general TP, cases of TP following LNG-EC failure exhibited reduced rates of CT infection, fallopian tubal inflammation, and/or fibrosis.
authors.affiliation: Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Li
authors.forename: Chun-Xia
authors.initials: CX
authors.lastname: Meng
authors.forename: Lu-Lu
authors.initials: LL
authors.lastname: Sun
authors.forename: Wei-Hong
authors.initials: WH
authors.lastname: Zhao
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Linan
authors.initials: L
authors.lastname: Cheng
mesh_terms: D000328:Adult; D002908:Chronic Disease; D044363:Contraception, Postcoital / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005865:Gestational Age; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012488:Salpingitis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D017211:Treatment Failure
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: emergency contraception; levonorgestrel; pelvic inflammatory disease; pharmacoepidemiology; tubal pregnancy
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