Publikation

Optimal treatment for patients with ectopic pregnancies and a history of fertility-reducing factors

Wissenschaftlicher Artikel/Review - 10.11.2009

Bereiche
Schlagwörter (Tags)
Ectopic pregnancy – Laparoscopy – Reproductive outcome – Salpingectomy – Salpingotomy – Fertility-reducing factors – Tubal preserving surgery
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Zitation
Hornung R, Becker S, Solomayer E, Kurek R, Banys M, Aydeniz B, Franz H, Wallwiener D, Fehm T. Optimal treatment for patients with ectopic pregnancies and a history of fertility-reducing factors. Archives of gynecology and obstetrics 2009; 283:41-45.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Archives of gynecology and obstetrics 2009; 283
Veröffentlichungsdatum
10.11.2009
Seiten
41-45
Kurzbeschreibung/Zielsetzung

With most ectopic pregnancy (EP) cases now diagnosed and treated early, a major concern has become future reproductive outcome. The aim of this study was to evaluate long-term reproductive outcome after salpingotomy versus salpingectomy in patients with and without additional fertility-reducing factors.


Methods

As part of a prospective follow-up study, 261 patients underwent laparoscopic management of EP at our institution. History was taken specifically looking at preexisting risk factors for reduced fertility. Patients were then followed with regard to future reproductive events.


Results

Of 261 patients, 196 (75%) reported a subsequent desire for pregnancy. 145 patients had undergone salpingotomy and 51 salpingectomy. In patients without prior history of fertility-reducing factors, the subsequent intrauterine pregnancy rates were >90% for both salpingotomy and salpingectomy groups irrespective of the surgical approach. In patients with preexisting fertility-reducing factors, postoperative intrauterine pregnancy rates were 75% in the salpingotomy group, but only 40% in the salpingectomy group (p < 0.05), showing maximal effect for conservative surgery.


Conclusion

Laparoscopic salpingotomy is of particular benefit for patients with additional fertility-reducing factors desirous of future pregnancy. Reproductive outcome is excellent in patients without such risk factor, irrespective of the surgical approach.