Document Detail


Comparison of a local injection of hyperosmolar glucose solution with salpingostomy for the conservative treatment of tubal pregnancy.
MedLine Citation:
PMID:  7685719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare a local injection of hyperosmolar glucose and salpingostomy for the laparoscopic treatment of tubal pregnancy in terms of immediate success and postoperative tubal patency. DESIGN: Prospective. PATIENTS, SETTING: Forty women with an unruptured tubal pregnancy were enrolled from among 117 women with ectopic pregnancies (EPs) admitted consecutively to the university clinic. The inclusion criteria were as follows: [1] concentration of beta-hCG in the serum < or = 5,000 IU/L; [2] no living fetus in the EP; and [3] unruptured tubal pregnancy at laparoscopy. INTERVENTIONS: After randomization, 20 of these patients were treated with a local injection of hyperosmolar (50%) glucose solution and 20 women by salpingostomy. Tubal patency was evaluated at relaparoscopy or by hysterosalpingography 6 to 13 months after the primary treatment. RESULTS: The mean decrease in beta-hCG concentration from the preoperative value to the first postoperative day was 37% and 52% in the glucose and salpingostomy groups, respectively, and the mean resolution time was 13 and 12 days, respectively. Human chorionic gonadotropin showed a persistent EP in 4 women (20%) in the glucose group and 2 (10%) in the salpingostomy group. A patent treated tube was found in 9 of 13 women in the glucose group and 9 of 10 in the salpingostomy group at re-examination. During a follow-up of 6 to 20 months 4 women in the glucose group and 4 women in the salpingostomy group had an intrauterine pregnancy. CONCLUSION: A local injection of hyperosmolar glucose is a reasonable method treating tubal pregnancy in selected cases but does not seem to offer any advantage over salpingostomy concerning persistent trophoblastic disease rate.
Authors:
T Laatikainen; L Tuomivaara; K Käär
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Fertility and sterility     Volume:  60     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-07-22     Completed Date:  1993-07-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  80-4     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Oulu University Central Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / blood*
Chorionic Gonadotropin, beta Subunit, Human
Female
Glucose Solution, Hypertonic / administration & dosage*
Humans
Laparoscopy
Peptide Fragments / blood*
Pregnancy
Pregnancy, Tubal / blood,  therapy*
Prospective Studies
Salpingostomy*
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Chorionic Gonadotropin, beta Subunit, Human; 0/Glucose Solution, Hypertonic; 0/Peptide Fragments

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