204: Laparoscopic Management of Atypical Presentation of Ectopic Pregnancy

Abstract

To analysis twenty two hemodynamically stable patients of ectopic pregnancy clinically presented as an atypical form for accuracy of diagnosis, operative details and post operative morbidity. Three year, retrospective analysis. Victory Nursing & Infertility Management Centre, Khulna. Twenty-two. Laparoscopic Surgery. Twenty two patients with atypical presentation of ectopic pregnancy were successfully managed laparoscopically. All patients have dull ache pain in lower abdomen or any one iliac fossa. Regular and irregular menstrual pattern were 54.5% and 45.4% respectively, ultrasound findings were complex heterogeneous mass without any free fluid in 8 cases, definitive gestational sac 6, saclike structure 8 cases. Urinary β-hCG was positive 40.9% and negative 59%. Pre-operative diagnoses were chronic ectopic pregnancy 11, ruptured corpus luteum 6 and chocolate cyst 5. Operative diagnoses were chronic ectopic pregnancy 14, unruptured tubal pregnancy 5, ovarian ectopic 3. Surgical procedures were salpingostomy, salpingectomy, salpingoophrectomy, partial ovarian resection and only removal of sac with peritoneal toileting. Average operating time was 30–120 minutes. The average post-operative stay was 24–48 hours without any complications. Ectopic pregnancy does not present always typical form. In suspected cases these guidelines should help the gynecologist’s decision making for best obstetric outcome and able them to understand different possibilities.