Document Detail


Risk factors for conversion to laparotomy during laparoscopic management of an ectopic pregnancy.
MedLine Citation:
PMID:  15991011     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify risk factors for conversion to laparotomy during laparoscopic management of ectopic pregnancy. METHODS: A retrospective chart review of patients who underwent laparoscopy for treatment of ectopic pregnancy, during a 32-month period (6/1999-2/2002), at the University of Miami Jackson Memorial Hospital. We identified 229 patients; 201 had a successful laparoscopy (non-converted group) and 28 who were converted to laparotomy (converted group). Variables analyzed between the two groups were demographic data, patient-related risk factors available to the surgeon prior to the surgery (previous laparotomy, previous laparoscopy, history of PID, history of endometriosis, diameter of ectopic pregnancy as measured by ultrasound, amount of free fluid on ultrasound, BMI), and surgeons' experience. RESULTS: Out of the 229 laparoscopies, 28 were converted to laparotomy (12.2%). The rate of conversion was significantly higher for less experienced compared to experienced surgeon (OR = 6.1, 95% CI = 2.35-15.88). Significantly more women had a BMI > 30 kg/m2 in the converted group compared to the non-converted group (42% vs. 14%; OR = 4.28, 95% CI = 1.7-10.75) and the converted group had significantly higher rate of large free fluid reported on ultrasound compared to the non-converted group (21.42% vs. 7.46%; OR = 3.38, 95% CI = 1.04-10.61). CONCLUSION: Less experienced surgeon, BMI > 30 kg/m2, and large amount of free fluid on ultrasound increase the risk of conversion to laparotomy during laparoscopic management of ectopic pregnancy.
Authors:
Peter Takacs; Greg Latchaw; Lucia Gaitan; Nahida Chakhtoura; Timothy De Santis
Publication Detail:
Type:  Journal Article     Date:  2005-10-28
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  273     ISSN:  0932-0067     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-04     Completed Date:  2007-01-25     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  32-4     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology (D-50) Jackson Memorial Hospital, University of Miami School of Medicine, P.O. Box 016960, Miami, FL 33010, USA. ptakacs@med.miami.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Body Mass Index
Clinical Competence
Female
Humans
Laparoscopy*
Laparotomy*
Pregnancy
Pregnancy, Ectopic / surgery*,  ultrasonography
Risk Factors
Treatment Failure

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


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