A comparative case-controlled study of laparoscopic vs. laparotomy management of ectopic pregnancy: an evaluation of reproductive performance after radical vs. conservative treatment of tubal ectopic pregnancy

Abstract

Ectopic pregnancy is the most common cause of maternal death in early pregnancy (RCOG 1997-1999) and its incidence is rising. Most of the ectopic pregnancies occur in the young age group and subsequent fertility is an important issue. Laparoscopic surgery has advantages over open surgery and results in higher rates of subsequent intrauterine pregnancies and a lower rate of ectopic pregnancy (Fernandez, 1998). There is no consensus in the literature regarding conservative versus radical treatment of tubal pregnancy in terms of future reproductive performance (Hajenius, 2000). There are no randomised controlled trials of sufficient power, and meta-analysis of studies has shown different results with different investigators (Yao, 1997; Clausen, 1996). Most of the studies have shown higher intrauterine pregnancy (IUP) rates after salpingotomy (2-23% higher IUP rates) than after salpingectomy. We carried out this study in the East Birmingham Hospitals (Teaching) NHS Trust, West Midlands UK, to contribute to the ongoing debate.