Successful management of unruptured interstitial pregnancy in 17 consecutive cases by using laparoscopic surgery.
Summary of "Successful management of unruptured interstitial pregnancy in 17 consecutive cases by using laparoscopic surgery."
AIMS:
To analyse the optimal laparoscopic surgical techniques for the treatment of interstitial pregnancy to minimise bleeding during the operative procedure and the safety of the subsequent pregnancy.
METHODS:
Advanced bipolar coagulator was used to achieve haemostasis.
RESULTS:
The mean gestational age was 55 ± 5.1 days. All 17 women with an interstitial pregnancy were successfully treated by laparoscopic surgery without any complication. No surgery was converted to laparotomy. The mean pre-operative beta-human chorionic gonadotropin (β-hCG) serum concentration was 14 696 ± 11 705 mIU/mL. This value decreased to 1911 ± 1769 mIU/mL at 3-day post-operation. Among women who underwent laparoscopic surgery, a cornual resection was performed in 16 (94.1%) cases. One (5.8%) woman underwent a laparoscopic evacuation of the conceptus and received a local injection of 10 mg methotrexate. The volume of blood loss was <25 mL in 16 cases. However, one woman experienced a rupture at the beginning of the operation and lost 250 mL of blood. The mean hospital stay was 4.5 days. Four of the nine women who chose to retain their reproductive function had subsequent normal pregnancies, but all received an elective caesarean delivery prior to labour.
CONCLUSIONS:
The laparoscopic management of women with unruptured interstitial pregnancy can frequently be performed without haemorrhage or complication using advanced bipolar coagulation. The small sample of successful subsequent pregnancies demonstrates the safety and effectiveness of this technique, but this finding should be confirmed by further investigations.
Affiliation
Department of Obstetrics and Gynaecology, The Jinshan Hospital of Shanghai Medical College, Fudan University, Shanghai, China; Department of Obstetrics and Gynaecology, Tongji Hospital of Tongji University, Shanghai, China; Department of Obstetrics and Gy
Journal Details
This article was published in the following journal.
Name: The Australian & New Zealand journal of obstetrics & gynaecology
ISSN: 1479-828X
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22676439
- DOI: http://dx.doi.org/10.1111/j.1479-828X.2012.01455.x
Medical and Biotech [MESH] Definitions
Pregnancy Proteins
Proteins produced by organs of the mother or the PLACENTA during PREGNANCY. These proteins may be pregnancy-specific (present only during pregnancy) or pregnancy-associated (present during pregnancy or under other conditions such as hormone therapy or certain malignancies.)
Endometrium
The mucous membrane lining of the uterine cavity that is hormonally responsive during the MENSTRUAL CYCLE and PREGNANCY. The endometrium undergoes cyclic changes that characterize MENSTRUATION. After successful FERTILIZATION, it serves to sustain the developing embryo.
Obstetrics
A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.
Pregnancy In Diabetics
The state of PREGNANCY in women with DIABETES MELLITUS. This does not include either symptomatic diabetes or GLUCOSE INTOLERANCE induced by pregnancy (DIABETES, GESTATIONAL) which resolves at the end of pregnancy.
Materials Management, Hospital
The management of all procurement, distribution, and storage of equipment and supplies, as well as logistics management including laundry, processing of reusables, etc.
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