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Surgical treatment of ectopic pregnancy associated with predisposing factors of tuboperitoneal infertility.
MedLine Citation:
PMID:  22861158     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: We sought to study the advantages of laparoscopic conservative treatment and pelvic reproductive surgery in patients with ectopic pregnancy and predisposing factors of tuboperitoneal infertility. Material and methods: Patients who had undergone laparoscopic treatment for ectopic pregnancy were considered, with factors for tuboperitoneal infertility, while patients who underwent previous salpingectomy or assisted reproductive technology were excluded. The groups treated by salpingotomy (conservative) or salpingectomy (radical) were compared in terms of spontaneous intrauterine pregnancy rate, cumulative one-year pregnancy rate and recurrence of ectopic pregnancy. We considered patients treated with adhesiolysis, fimbrioplasty, and neosalpingostomy for tubal pathology as part of the fertility surgery group. Results: Among 41 considered patients, 21 (51%) underwent conservative laparoscopic management of ectopic pregnancy. Twenty patients (49%) had salpingectomy. Despite the treatment of tuboperitoneal infertility factors in both groups, the pregnancy rate was significantly higher in the conservative group than in the radical one (76% vs 25%, p < 0.05). The overall cumulative rate of ectopic pregnancy recurrence was 22% and no significant difference was found between conservative and radical treatment (p 0.645). Conclusions:Salpingotomy should be preferred in all patients with ectopic pregnancy associated with factors of tuboperitoneal infertility. Infertility surgery clearly cannot help patients treated with salpingectomy, who obtain lower spontaneous pregnancy rates than those of the conservative group.
Authors:
Angelo Calcagno; Ambrogio P Londero; Thierry Haag; Lorenza Driul; Serena Bertozzi; Tiziana Grassi; Diego Marchesoni; Hubert Manhes
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-6
Journal Detail:
Title:  Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy     Volume:  -     ISSN:  1365-2931     ISO Abbreviation:  Minim Invasive Ther Allied Technol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612996     Medline TA:  Minim Invasive Ther Allied Technol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Clinic of Obstetrics and Gynecology, AOU "SM della Misericordia" , Udine , Italy.
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