The conservative surgical management of unruptured ectopic pregnancy

Alan DeCherney, Nathan Kase

Research output: Contribution to journalArticlepeer-review

94 Scopus citations

Abstract

With the earlier and more accurate diagnosis of ectopic pregnancy based on rapid [beta]-subunit pregnancy tests and the use of ultrasound and laparoscopy, the percentage of diagnosed unruptured ectopic pregnancies is rapidly increasing. This, coupled with the earlier treatment of pelvic inflammatory disease, the use of IUDs, and increasing numbers of tubal plastic surgery, caused the authors to evaluate the problem of conservative management of ectopic pregnancy. In this study 98 patients at the Yale-New Haven Hospital who had ectopic pregnancies between 1972 and 1977 are evaluated. Fifty of these patients underwent a salpingectomy or salpingo-oophorectomy. Forty-eight patients underwent salpingostomy. This represents an increase in the conservative surgery rate from 8 to 35.5%. The overall term viable pregnancy rate was 40%, along with a 10% repeat ectopic rate. There was no advantage as far as term viable pregnancy when comparing salpingostomy and salpingectomy. Conservative surgery did not increase the repeat ectopic rate. Salpingostomy is therefore recommended in unruptured ampullar ectopic pregnancies in order to preserve reproductive function. If current trends continue, this will be an increasingly important problem. The statistics are based on a 73% follow-up, with all patients actively trying to conceive.

Original languageEnglish
Pages (from-to)451-455
Number of pages5
JournalObstetrics and Gynecology
Volume54
Issue number4
StatePublished - Oct 1979
Externally publishedYes

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