Laparoscopic management of ectopic pregnancies: a comparison between interstitial and "more distal" tubal pregnancies.

Nirgianakis, Konstantinos; Papadia, Andrea; Grandi, Giovanni; Mc Kinnon, Brett; Bolla, Daniele Maik; Mueller, Michael (2017). Laparoscopic management of ectopic pregnancies: a comparison between interstitial and "more distal" tubal pregnancies. Archives of gynecology and obstetrics, 295(1), pp. 95-101. Springer 10.1007/s00404-016-4191-x

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BACKGROUND/AIMS Laparoscopy is an established, safe, and feasible management option for tubal pregnancies, even in women with significant hemoperitoneum. In case of interstitial pregnancy, however, a laparoscopic surgical approach is still a matter of debate. The objective of this study is to evaluate the safety and feasibility of a laparoscopic approach to interstitial pregnancies. METHODS A total of 92 women with ectopic pregnancy who underwent a surgical management from April 2009 to August 2015 were reviewed. Clinical and surgical outcomes of confirmed interstitial pregnancies (n = 10) (IP group) were compared with those of "more distal" tubal pregnancies (n = 79) (TP group). RESULTS Although there were no differences between the two groups in gestational age, ß-hCG values were significantly higher in the IP group (p = 0.005). All patients with IP were treated by laparoscopic wedge resection. The rate of surgical complications (p = 0.413) and subsequent MTX treatment (p = 0.531) were not significantly different between groups. Operating room (OR) time (p = 0.007) was higher in the IP than in the TP group. After stratification for the presence of hemoperitoneum this difference remained, with patients in the IP group having longer OR time (p = 0.034) and additionally higher intra-operative blood loss (EBL) (p = 0.013). On the other hand, in the absence of hemoperitoneum no differences between the two groups were observed. CONCLUSIONS In experienced hands, the laparoscopic management of interstitial pregnancies seems to be as safe and feasible as that of other tubal pregnancies. However, it could be technically more challenging, especially in case of hemoperitoneum.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Endometriose und gynäkologische Onkologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Endometriose und gynäkologische Onkologie

UniBE Contributor:

Nirgianakis, Konstantinos; Papadia, Andrea; Grandi, Giovanni; Mc Kinnon, Brett; Bolla, Daniele Maik and Mueller, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0932-0067

Publisher:

Springer

Language:

English

Submitter:

Monika Zehr

Date Deposited:

18 Jul 2017 10:14

Last Modified:

17 Aug 2017 09:53

Publisher DOI:

10.1007/s00404-016-4191-x

PubMed ID:

27581585

Uncontrolled Keywords:

Cornual pregnancy; Ectopic pregnancy; Extrauterine pregnancy; Interstitial pregnancy; Laparoscopy

BORIS DOI:

10.7892/boris.94511

URI:

https://boris.unibe.ch/id/eprint/94511

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