Document Detail


Proximal ectopic pregnancy: a descriptive general population-based study and results of different management options in 86 cases.
MedLine Citation:
PMID:  21047630     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To describe different approaches for diagnosis and management of proximal ectopic pregnancies (PP) in general population.
DESIGN: Observational population based-study.
SETTING: Regional ectopic pregnancy registry.
PATIENT(S): Eighty-six PP registered from 1992 to 2008.
INTERVENTION(S): Surgical (radical or conservative), medical, or combined therapies.
MAIN OUTCOME MEASURE(S): Epidemiologic characteristics, clinical presentation, hCG level, treatments performed, failure rate, and recurrence.
RESULT(S): Mean gestational age was 48.2 days. Estimated incidence of PP was 2.7%. Abdominal pain and vaginal bleeding were the commonest symptoms. Two patients were admitted in hypovolemic shock. Diagnostic modalities included transvaginal ultrasound, abdominal ultrasonography, and laparoscopy in 38 (44%), 7 (8%), and 39 (45%) cases, respectively. Mean hCG level was 10,759 IU/L. Thirty-four patients underwent primary cornual resection (39.5%) by laparoscopy (n = 32) or laparotomy (n = 2). Twenty-seven patients (31.4%) underwent primary conservative surgery by laparoscopy: cornuostomy (n = 18) or extended salpigostomy (n = 9). Primary medical treatment with methotrexate was attempted in 14 patients (16.3%). Expectant management was attempted in one case (1.2%). Eleven cases received combined therapies (11.6%). Failure rates for medical and surgical treatments were 35.7% and 28%, respectively. No failures were noted among patients who received combined therapies.
CONCLUSION(S): Proximal ectopic pregnancy remains a life-threatening condition. Diagnosis is challenging and requires a high index of suspicion. Despite available conservative strategies, management of PP remains heterogeneous.
Authors:
Demetrio Larraín; Francesca Marengo; Nicolas Bourdel; Patricia Jaffeux; Bruno Aublet-Cuvelier; Jean-Luc Pouly; Gerard Mage; Benoit Rabischong
Publication Detail:
Type:  Journal Article     Date:  2010-11-03
Journal Detail:
Title:  Fertility and sterility     Volume:  95     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  867-71     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire, Estaing, Clermont-Ferrand, France.
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