Document Detail


New simple endoscopic operations for interstitial pregnancies.
MedLine Citation:
PMID:  10649165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our aim was to report a new approach of endoscopic management (endoloop and encircling suture methods) for interstitial or cornual pregnancy and to determine the safety and effectiveness of these procedures and their effects on subsequent pregnancies. STUDY DESIGN: This is an uncontrolled retrospective review of 24 patients treated for interstitial pregnancies through endoscopic operations with 14 to 72 months of follow-up at a large urban medical center. Blood loss, operation time, changes of serum human chorionic gonadotropin levels, the resumption of menstruation, and subsequent pregnancy after operation were analyzed. RESULTS: Among 24 interstitial pregnancies, 3 had ruptured at the time of operation and 21 had not ruptured. Treatment consisted of either the vasopressin and electric cauterization method, the endoloop before evacuation of the conceptus method, or the encircling suture before evacuation of the conceptus method. The blood loss and operation time (mean +/- SD) for unruptured cases were 133 +/- 134 mL and 51.6 +/- 7.6 minutes in the vasopressin and electric cauterization group (n = 3), 32 +/- 22 mL and 28.5 +/- 6.4 minutes in the endoloop group (n = 15), and 40 +/- 17 mL and 35.0 +/- 5.0 minutes in the encircling suture group (n = 3). In 3 patients with ruptured pregnancy treated with the endoloop method, the blood loss and operation time (mean +/- SD) were 1100 +/- 854 mL and 82.5 +/- 51.6 minutes. Any of these operative methods resulted in rapid decline of serum human chorionic gonadotropin levels within 1 week with the exception of 1 case, in which the endoloop method was used; this patient needed additional treatment with methotrexate. Seventeen patients desired pregnancy in the future, and 15 eventually became pregnant. One of these 15 pregnancies ended in an ectopic pregnancy on the opposite side 6 months after the interstitial pregnancy. Three ended in a spontaneous abortion, and 11 were delivered by elective cesarean section at term before labor started. Operative records of cesarean section in 8 patients delivered at our institution showed little or no adhesions or defect in the cornual area of the previous operation. CONCLUSION: The endoloop method and the encircling suture method are simple, safe, effective, and nearly bloodless. There were no uterine ruptures in the pregnancies subsequent to these methods of endoscopic management.
Authors:
H S Moon; Y J Choi; Y H Park; S G Kim
Related Documents :
844965 - Angular and interstitial pregnancy.
17763455 - Ectopic pregnancy in a cesarean section scar treated with intramuscular methotrexate an...
9219125 - A new laparoscopic technique for interstitial pregnancy resection. a case report.
3134425 - Sonographic detection of interstitial pregnancy.
12119865 - The female athlete. before and beyond puberty.
2015245 - Teenage pregnancy: comparison with two groups of older pregnant women.
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  182     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-17     Completed Date:  2000-02-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  114-21     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Laparoscopic Surgery, Moon Hwa Hospital.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Blood Loss, Surgical
Cesarean Section
Chorionic Gonadotropin / blood
Electrocoagulation
Endoscopy*
Female
Humans
Menstruation
Pregnancy
Pregnancy Outcome
Pregnancy, Ectopic / surgery*
Retrospective Studies
Rupture, Spontaneous
Time Factors
Treatment Outcome
Vasopressins / therapeutic use
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 11000-17-2/Vasopressins

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


Previous Document:  Comparison of the Bishop score, ultrasonographically measured cervical length, and fetal fibronectin...
Next Document:  A multicenter, placebo-controlled pilot study of intravenous immune globulin treatment of antiphosph...