The Value of Hysterosalpingography following Medical Treatment with Methotrexate for Ectopic Pregnancy

Abstract

After an ectopic pregnancy (EP) fertility decreases, mostly due to tubal factor. Hysterosalpingography (HSG) is the most cost-effective tool for tubal patency assessment. Objective. To evaluate the usefulness of a HSG after a medical treatment for an EP, in order to counsel women on the most appropriate way to conceive future pregnancies. Methods. Between 1998 and 2008, 144 patients were submitted to medical treatment for an EP and performed HSG 3 months after the event. Results. 72.2% of normal HSG, 18.8% with unilateral obstruction, 6.3% tubal patency with defect, and 2.8% bilateral obstruction. Conclusion. Routine HSG following medical treatment for an EP does not seem necessary, as it does not change the initial management in 97.2% of the cases, but might be considered in selected risk cases, permitting timely referral of patients to in vitro fertilization.

Laparoscopic Excision of Coexisting Left Tubal and Right Pseudotubal Pregnancy after Conservative Management of Previous Ectopic Pregnancy with Methotrexate: An Unusual Clinical Entity

“…Therefore, it allows better assessment of the likelihood of a future pregnancy. Furthermore a number of medically managed patients may require subsequent surgery due to treatment failure [8, 9]. In this case, we performed laparoscopy in order to treat the subsequent contralateral ectopic pregnancy settled down at the left Fallopian tube.…”

“…These results confirm adverse impact of an ectopic pregnancy in future fertility, as in many cases Fallopian tube never returns to its natural morphological status, according to the former HSG findings. This study is pointing out another issue; that is, the identified alterations in tubes might have preexisted and may have caused the ectopic implantation [9]. …”

Implementing a holistic approach to a radiographer-led Hysterosalpingogram (HSG) service: A review of impact and patient perception

“…7 The first HSG was performed in 1910 and was considered to be the first specialised radiologic procedure. 8 To this day HSG's still remain the best procedure to image the fallopian tubes and are predominantly used in the evaluation of infertility. Other reasons for performing HSG examinations include follow up to sterilisation procedures and to assess congenital uterine anomalies.…”

Widening the Field of Indication of Conservative Management of Unruptured Tubal Pregnancy in Low Resources Settings: Lessons Learnt from 10-year Experience in Three University Teaching Hospitals in Yaoundé (Cameroon)

“…[12]. This is an important advantage as some of EP are suffering from infertility, an established risk of EP and cases of tubal re-permeability after MTX have been described [12][13].…”