Salpingotomy vs salpingectomy – a comparison of women’s fertility after surgical treatment of tubal ectopic pregnancy during a 24-month follow-up study

Kostrzewa, Marta; Żyła, Monika; Kolasa-Zwierzchowska, Dorota; Szpakowski, A; Stachowiak, Grzegorz; Szpakowski, M; Wilczyński, Jacek R.; Litwińska, Ewelina

doi:10.17772/gp/1675

Cited by 7 publications

(14 citation statements)

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“…Thirteen had medical management of previous ectopic pregnancy. In a Polish study [4] by Kostrzewa et al who compared women's fertility after surgical treatment of tubal ectopic pregnancy during a 24-month follow-up, recurrent risk of ectopic in 13.6% cases following salpingotomy versus 19.4% following salpingectomy. In another study by de Bennetot et al [5], the 2-year cumulative rate of recurrences was 18.5% after salpingostomy or salpingectomy and 25.5% after medical treatment.…”

Section: Discussionmentioning

confidence: 99%

Ectopic Pregnancy: Risk Factors, Clinical Presentation and Management

Ranji

Rani

Varshini

2017

J Obstet Gynecol India

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Background Ectopic pregnancy is increasing in incidence. Nevertheless, there is wide availability of tools for early diagnosis and advances in management. Though it is not a leading cause of maternal mortality, it significantly causes morbidity and jeopardizes reproductive outcome in women desirous of fertility. Aims To determine incidence, risk factors, symptoms, signs, type of ectopic pregnancy and management.

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Section: Discussionmentioning

confidence: 99%

Ectopic Pregnancy: Risk Factors, Clinical Presentation and Management

Ranji

Rani

Varshini

2017

J Obstet Gynecol India

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“…Instead, in our study, a preapproved protocol adopted before the study period guided the choice of treatment option in all cases. Finally, the inclusion of only women who actively tried to conceive after the first tubal EP and the long follow-up (12-80 months) strength the study results and limit possible bias present in previous reports [30,31].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Fertility and reproductive outcome after tubal ectopic pregnancy: comparison among methotrexate, surgery and expectant management

Baggio

Garzon

Russo

et al. 2020

Arch Gynecol Obstet

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Purpose To compare fertility and reproductive outcome after surgical, medical, and expectant management for tubal ectopic pregnancy (EP). Methods 133 of 228 patients, who were managed between January 2012 and December 2017 for a tubal EP, tried to conceive immediately after treatment: 86 out of 173 (49.7%) underwent surgical treatment; 38 (21.9%) were treated with methotrexate (MTX), and 49 (28.3%) had expectant management. Clinical data were retrieved by medical records, fertility outcomes were obtained by phone follow-up. The cumulative incidence (CI) of intrauterine clinical pregnancy (CP), miscarriage, live birth (LB), and recurrent EP, and the time between treatment and first intrauterine CP were compared between women treated with MTX, surgery and expectant management. Results The CI of intrauterine CP starting from 12 months after the EP was 65.3% for the expectant management, 55.3% for the MTX group, and 39.5% for surgery (p = 0.012). Post-hoc analysis showed expectant management having higher intrauterine CP and LB, and shorter time between treatment and first intrauterine CP compared to surgery (p < 0.05). The CI of recurrent EP was comparable between the 3 groups. The analysis stratified per βhCG cut-off of 1745 mUI/mL and EP mass cut-off of 25 mm reported consistent results. Conclusions Women successfully managed by expectation appear to have better reproductive outcomes compared to women who underwent surgery, with the shortest time to achieve a subsequent intrauterine CP. Therefore, if safely applicable the expectant management should be considered in the case of tubal EP. The fact that the chosen treatment was primarily guided by the βhCG value and EP mass diameter based on the protocol, which is intrinsically related to the characteristics of the EP, represents the main limitation of the present study. Indeed, we cannot completely exclude that the observed differences between treatments are related to the EP itself instead of the treatment.

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“…The surgical treatment of tubal pregnancy includes tubal sparing focus clearance (conservative operation) and salpingectomy on the affected side. Some studies have suggested that previous treatment of EP with a conservative operation had a comparable risk of REP as salpingectomy (19,20). The results of this study showed that comparing with salpingectomy, the risk of REP after a conservative operation was increased.…”

Section: Previous History Of Ep and Repmentioning

confidence: 55%

Risk Factors of Recurrent Ectopic Pregnancy in Patients Treated With in vitro Fertilization Cycles: A Matched Case-Control Study

Shi

et al. 2020

Front. Endocrinol.

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Objective: To study the risk factors for recurrent ectopic pregnancy (REP) in patients undergoing in vitro fertilization (IVF). Methods: This was a 1:4 matched case-control study that enrolled 227 REP patients and 908 matched intrauterine pregnancy (IUP) patients from the assisted reproductive technology (ART) center of the First Affiliated Hospital of Zhengzhou University from January 2012 to November 2019. Univariate analysis was carried out between the two groups for the occurrence of REP. Multivariate logistic regression analysis was used to explore the risk factors of REP after IVF. Results: The results of univariate analysis showed that there were significant differences in previous treatment of EP, stage of embryo and the number of embryos transferred between the two groups (all P < 0.05). The other factors did not have a significant effect on the probability of developing REP. Multivariate logistic regression analysis showed that after adjusting for confounders, previous treatment of EP, type of embryos transferred and stage of embryo were related to the occurrence of REP (all P < 0.05). Conclusion: Conservative treatment, frozen-thawed embryo transfer and cleavage embryo transfer were independent risk factors for REP after ART treatment.

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Salpingotomy vs salpingectomy – a comparison of women’s fertility after surgical treatment of tubal ectopic pregnancy during a 24-month follow-up study

Cited by 7 publications

References 0 publications

Ectopic Pregnancy: Risk Factors, Clinical Presentation and Management

Ectopic Pregnancy: Risk Factors, Clinical Presentation and Management

Fertility and reproductive outcome after tubal ectopic pregnancy: comparison among methotrexate, surgery and expectant management

Risk Factors of Recurrent Ectopic Pregnancy in Patients Treated With in vitro Fertilization Cycles: A Matched Case-Control Study

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