Laparoscopic Management of 42 Cases of Tubal Stump Pregnancy and Postoperative Reproductive Outcomes

Sun, Feng; Yang, Siqin; Yang, Yeping; Liu, Xiaoyi; Xu, Hong

doi:10.1016/j.jmig.2019.04.030

Cited by 13 publications

(10 citation statements)

References 26 publications

(28 reference statements)

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“…Treatment options include conservative medical management using methotrexate and surgery. Successful surgical treatment using laparoscopy has been previously reported [1,2]. This case demonstrates that vNOTES may be a minimally invasive option for the surgical treatment of tubal stump pregnancy in selected cases.…”

mentioning

confidence: 64%

Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Tubal Stump Pregnancy

Özçeltik

Yeniel

Atay

et al. 2021

Journal of Minimally Invasive Gynecology

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Objective: To demonstrate a case of left tubal stump pregnancy successfully treated using our 2-step technique for transvaginal natural orifice transluminal endoscopic surgery (vNOTES). Design: Demonstration of the technique using surgical video footage. Setting: Tertiary university hospital. Interventions: A 27-year-old gravida 3 para 0 patient with a history of laparotomy, left salpingectomy owing to a ruptured tubal pregnancy, was referred to our hospital because of a pregnancy of unknown location. Her serum b human chorionic gonadotropin level was 8400 U/L, and a transvaginal ultrasound revealed an ectopic pregnancy in the left tubal stump. After discussing medical and surgical treatment options, the patient underwent a 2-step vNOTES approach. First, a diagnostic vNOTES was performed using a 5-mm trocar with autoretracting blade. After confirmation of the diagnosis, the trocar was removed, and the incision was enlarged with blunt dissection. A self-constructed pessary port was then placed through the enlarged colpotomy, and the ectopic pregnancy in the left tubal stump was excised using an advanced bipolar device. The colpotomy was closed with running resorbable sutures. The duration of the surgery was 36 minutes, and the patient was discharged on postoperative day 1 without any complications. Conclusion: Tubal stump pregnancy is a rare form of ectopic pregnancy with an incidence of approximately 0.4% of all ectopic pregnancies [1]. Treatment options include conservative medical management using methotrexate and surgery. Successful surgical treatment using laparoscopy has been previously reported [1,2]. This case demonstrates that vNOTES may be a minimally invasive option for the surgical treatment of tubal stump pregnancy in selected cases.

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mentioning

confidence: 64%

Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Tubal Stump Pregnancy

Özçeltik

Yeniel

Atay

et al. 2021

Journal of Minimally Invasive Gynecology

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“…This frequency remained stable throughout the period of analysis, despite the increased use of clinical treatment and laparoscopy. The non-fatal complications of ectopic pregnancy are poorly studied [23]. Some observational studies have reported surgical complications in 23.4% of cases [24] and blood transfusion rates of 4.8% regardless of the type of treatment [17].…”

Section: Resultsmentioning

confidence: 99%

Changing Paradigms in the Initial Treatment of Ectopic Pregnancy at a University Hospital in Brazil

Tavares¹,

Delfino²,

Ignarro³

et al. 2020

Preprint

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Background: to evaluate the use of different treatment options for ectopic pregnancy and the frequency of severe complications in a university hospital. Methods: observational study with women with ectopic pregnancy admitted at UNICAMP Women´s Hospital, Brazil, between 01/01/2000 and 12/31/2017. The outcome variables were the type of treatment (first choice) and the presence of severe complications. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out by the Cochran–Armitage test, chi-square test, Mann–Whitney test and multiple Cox regression. Results: 673 women were included in the study. The mean age was 29.0 years (±6.1) and the mean gestational age was 7.7 (±2.5). The frequency of surgical treatment decreased significantly over time (z=-4.69; p<0.001). Conversely, there was a significant increase in the frequency of clinical treatment (z=4.73; p<0.001). Seventy-one women (10.5%) developed some type of severe complication. In the final statistical model, the prevalence of severe complications was higher in women who were diagnosed with a ruptured ectopic pregnancy at admission (PR=2.97; 95%CI: 1.61–5.46), did not present with vaginal bleeding (PR=2.45; 95%CI: 1.41–4.25), had never undergone laparotomy/laparoscopy (PR=6.69; 95%CI: 1.62–27.53), had a non-tubal ectopic pregnancy (PR=4.61; 95%CI: 1.98–10.74), and do not smoke (PR=2.41; 95%CI: 1.08–5.36). Conclusion: there was a change in the first treatment option for cases of ectopic pregnancy in the hospital during the period of analysis. Factors inherent to a disease that is more difficult to treat are related to a higher frequency of severe complications.

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“…Tubal EP remains the most common cause of pregnancy-related mortality in the first trimester of pregnancy 4 . In recent years, early diagnosis has made the maternal death caused by EP more and more rare and the clinical emphasis has focused on optimizing treatment methods to preservation of fertility 5 – 7 or on the ability of women to obtain intrauterine pregnancy after EP 3 , 8 , 9 .…”

Section: Introductionmentioning

confidence: 99%

Time to pregnancy in women with previous ectopic pregnancy undergoing in vitro fertilization treatment: a retrospective cohort study

Xue

Zhang

2022

Sci Rep

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We aimed to investigate the difference in the time to pregnancy (TTP) between women with previous ectopic pregnancy (EP) and control women following in vitro fertilization (IVF) treatment and the association between TTP and the number of oocytes retrieved and embryos available. A retrospective study involving 1097 women, 547 of which had previous EP and 550 were control women whose previous pregnancy were abortion, was conducted. Women in the EP group had significantly longer median TTP than those in the control group (36; range, 12–252 vs 28; range, 12–220; P = 0.019). For women with previous EP, > 48 months TTP was most likely associated with low numbers of oocytes retrieved and embryos available compared to TTP of ≤ 24 months or 25–48 months, and women with younger age had a shorter TTP, higher numbers of oocytes retrieved and embryos available. A Cox proportional hazards model showed that maternal age was significantly related to the pregnancy over the TTP (adjusted hazard ratio, 0.934; P < 0.001). In conclusion, women with previous EP have a significantly increased TTP than control women with previous abortion. For women with previous EP, TTP is negatively associated with the numbers of oocytes retrieved and embryos available.

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Laparoscopic Management of 42 Cases of Tubal Stump Pregnancy and Postoperative Reproductive Outcomes

Cited by 13 publications

References 26 publications

Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Tubal Stump Pregnancy

Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Tubal Stump Pregnancy

Changing Paradigms in the Initial Treatment of Ectopic Pregnancy at a University Hospital in Brazil

Time to pregnancy in women with previous ectopic pregnancy undergoing in vitro fertilization treatment: a retrospective cohort study

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