Fertility after ectopic pregnancy: the DEMETER randomized trial

Abstract

NCT00137982 on the WHO International Clinical Trials Registry Platform.

An audit of extra-uterine pregnancy in a tertiary care facility in Northern India

“…It accounts for 2% of all pregnancies. [2][3][4] It remains the leading cause (9%) of pregnancy-related first trimester deaths worldwide. 4,5 Prompt diagnosis has furthered to a decline in associated morbidity.…”

“…[2][3][4] There has been an upsurge in its prevalence because of increase in the incidence of the risk factors predisposing to ectopic pregnancy especially ovulation stimulation as in artificial reproductive techniques, pelvic infection and tubal surgeries.…”

An audit on surgical management of Tubal ectopic pregnancies and patients’ preferences survey

“…The current debate is whether to perform conservative surgery or radical surgery. In the absence of statistically significant improvements in subsequent fertility rates, and the risks of recurrent ectopic pregnancy rates shown by RCTs 10,11 , patient's preference and individualized care appears to play an important role, despite popular recommendation of salpingectomy in the presence of macroscopically normal contralateral tube. This was also supported by the outcomes showed by the ectopic population register in France.…”

“…9 In two multicenter randomized control studies, there is no significant difference between Salpingectomy or Salpingotomy in terms of increased risk of recurrent ectopic pregnancy and subsequent fertility in medical, conservative surgical and radical surgical groups. 10,11 Therefore, in the absence of clear advantage or disadvantage in conservative Vs radical surgical management of ectopic pregnancy, the patients preference should play a major role in determining the treatment modality even with a macroscopically normal contra lateral tube. The aim of this audit is to ascertain whether the management of tubal ectopic pregnancy conforms to the guidelines set forth by the Royal College of Obstetricians and Gynaecologists of the United Kingdom and also to assess patient satisfaction and their preferences and whether such preferences were accommodated in decision making and the management of ectopic pregnancy, if they were educated and well-informed on current available data.…”

Factors influencing fertility outcome after ectopic pregnancy: a descriptive observational study

“…Once surgery is necessary, in more active ectopic pregnancies, should lead to a reconsideration of the balance between considerations of initial recovery and those of fertility preservation. 12 In the treatment of tubal ectopic laparoscopic treatment remain cornerstone of the treatment. 13 Laparoscopic salpingotomy has shown higher pregnancy rates compare laparotomy.…”