Document Detail


Management of unruptured ectopic gestation by linear salpingostomy: a prospective, randomized clinical trial of laparoscopy versus laparotomy.
MedLine Citation:
PMID:  2464777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was designed to compare prospectively the parameters of morbidity, cost, length of hospital stay, and fertility outcome after linear salpingostomy by laparoscopy versus laparotomy. Entry criteria included stable vital signs, hematocrit greater than 30%, age over 18 years, and desire for future fertility. All patients underwent diagnostic laparoscopy. Sixty patients with unruptured ectopic gestations of 5 cm or smaller were randomized to either laparoscopy (N = 30) or laparotomy (N = 30). Postoperative follow-up included serial measurements of serum beta-hCG titers at 3-day intervals and hysterosalpingography at 12 weeks. The laparoscopy and laparotomy groups were similar in age, height, weight, gravidity, gestational age, hematocrit, ectopic pregnancy size, and preoperative beta-hCG levels. The estimated blood loss was significantly (P less than .001) lower in patients undergoing laparoscopy, and was not affected by vasopressin injection. Two patients in the laparoscopy group required laparotomy for hemostasis, and two patients undergoing laparotomy had wound infection. One patient in each group had persistent trophoblastic activity. Baseline serum beta-hCG levels and the rate and magnitude of postoperative beta-hCG decline were similar in both groups. The length of hospital stay was significantly (P less than .001) shorter after laparoscopic salpingostomy (1.4 +/- 0.1 days) than after laparotomy (3.3 +/- 0.2 days). Postoperative hysterosalpingography showed patency of the involved tube in 16 of 20 (80%) and 17 of 19 (89%) of patients in the laparoscopy and laparotomy groups, respectively. Pregnancy rates were ten of 18 (56%) and 11 of 19 (58%) in these groups, respectively, and all pregnancies were conceived within 6 months of surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M Vermesh; P D Silva; G F Rosen; A L Stein; G T Fossum; M V Sauer
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  73     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-03-23     Completed Date:  1989-03-23     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  400-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / blood
Chorionic Gonadotropin, beta Subunit, Human
Clinical Trials as Topic
Female
Humans
Hysterosalpingography
Laparoscopy*
Laparotomy*
Length of Stay
Peptide Fragments / blood
Postoperative Complications
Pregnancy
Pregnancy, Tubal / blood,  radiography,  surgery*
Prospective Studies
Random Allocation
Rupture, Spontaneous
Salpingostomy / methods*
Grant Support
ID/Acronym/Agency:
R01 HD 19118-03/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Chorionic Gonadotropin, beta Subunit, Human; 0/Peptide Fragments
Comments/Corrections
Comment In:
Obstet Gynecol. 1989 Aug;74(2):282-3   [PMID:  2526311 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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