Implications of perihepatic adhesions in women undergoing laparoscopic surgery for ectopic pregnancy

Mullins, Edward; Agarwal, Nidheesh; Oliver, Reeba; Odejinmi, Jimi Funlayo

doi:10.1016/j.ijgo.2015.04.028

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…There were only two cases with perihepatic adhesions in the laparoscopic patients and none in the laparotomy patients as it was difficult to visualize the perihepatic surfaces in laparotomy. Mullins et al [12] found that among 802 patients with ectopic pregnancy managed surgically, 7.5% were found to have perihepatic adhesions. In all our patients, adhesions involving the tubes and ovaries were only seen in ten cases (5.6%), much lower than the finding of Horn et al [13] that 50% of ectopic pregnancies had evidence of tubal pathologies.…”

Section: Discussionmentioning

confidence: 99%

Clinical Predictive Factors Affecting Laparoscopic Approach in the Management of Ectopic Pregnancy: A Retrospective Cross-Sectional Study

Al-Husban,

Thekrallah,

Qatawneh

et al. 2023

Jordan Med. J.

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Introduction: Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Our aim was to study the preoperative clinical factors affecting the choice of laparoscopic approach to tubal ectopic pregnancy. Materials and methods: This was a retrospective cross-sectional study of tubal ectopic pregnancy cases that were managed by laparoscopy at an academic university hospital in the period January 2010 to December 2018. Cases that were managed medically or conservatively and laparoscopic cases that were converted to laparotomy were excluded. Cases where the surgical approach of laparoscopy or laparotomy were determined by the patients’ choice were also excluded. Results: The laparoscopy rate was 49.4%. The mean age was 32.04 years. Compared with laparotomy, laparoscopy was significantly associated with low parity (less than 3) (p=0.008), a low level of initial beta-human chorionic gonadotrophin (p=0.032), fewer cases of adnexal mass (p=0.000451), hemoperitoneum (p=0.000072), ruptured ectopic (p=0.000261), and more cases of bowel adhesions (p=0.0095). There was no significant difference between laparoscopy and laparotomy regarding the risk factors of ectopic pregnancy. Salpingectomy and salpingostomy were not significantly different between the two surgical approaches (p=0.643). Twenty-eight laparoscopic cases were converted to laparotomy. Conclusion: The laparoscopic approach to ectopic pregnancy was affected by parity, presenting symptoms of pain and vomiting, mean initial beta-human chorionic gonadotrophin, the presence of adnexal mass, the presence of hemoperitoneum, and the rupture of the ectopic. Bowel adhesions were seen more frequently in laparoscopy than laparotomy. Salpingectomy and salpingostomy were no different between laparoscopy and laparotomy.

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Section: Discussionmentioning

confidence: 99%

Clinical Predictive Factors Affecting Laparoscopic Approach in the Management of Ectopic Pregnancy: A Retrospective Cross-Sectional Study

Al-Husban,

Thekrallah,

Qatawneh

et al. 2023

Jordan Med. J.

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Implications of perihepatic adhesions in women undergoing laparoscopic surgery for ectopic pregnancy

Abstract: Women with PHAs at laparoscopy for EP had lower blood loss than did those without PHAs. The finding of PHAs was associated with an increased rate of recurrent EP, irrespective of a previous history of PID or EP.

Cited by 1 publication

References 15 publications

Clinical Predictive Factors Affecting Laparoscopic Approach in the Management of Ectopic Pregnancy: A Retrospective Cross-Sectional Study

Clinical Predictive Factors Affecting Laparoscopic Approach in the Management of Ectopic Pregnancy: A Retrospective Cross-Sectional Study

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