Abstract
BackgroundEctopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility. The objective of this study was to evaluate the recurrence and fertility rate after salpingostomy in patients with tubal ectopic pregnancy.MethodsThis cross-sectional retrospective study was conducted at four referral centers of Obstetrics and Gynecology, under the supervision of Shiraz University of Medical Sciences (Iran). The medical records of 125 patients with tubal pregnancy were reviewed. These patients underwent laparoscopic salpingostomy from April 2009 to March 2016.Data on maternal age, BMI, history of previous EP, genital tract infection, IUD insertion, history of previous surgery, and infertility were further obtained. The patients were followed up for approximately 1 to 7 years. The recurrence of EP and subsequent pregnancy rate were assessed during the follow-up period.ResultsThere was no statistically significant relationship between post-salpingostomy recurrence and maternal age, previous abdominopelvic surgery, and history of infertility(P = .425); however, the post-salpingostomy recurrence of EP was correlated with BMI (P = 0.001), previous history of EP (P = 0.001), genital tract infection (P = 0.001), and IUD insertion (P = 003). Among 95 women who had no contraception, pregnancy occurred in 51 cases (53.6%) and recurrence of EP was observed in 16 patients (12.8%).ConclusionsOur results suggest that salpingostomy is a safe method with a low risk of recurrence and good fertility outcomes for women who consider future pregnancy.
Highlights
Ectopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility
Among the 95 women who had no contraception, pregnancy occurred in 51 cases (53.6%) and ectopic pregnancy (EP) recurrence was seen in 16 cases (12.8%), 0.33% at the site of salpingostomy and0.67% in contralateral tube
Among the several well-known factors that augment the risk of ectopic pregnancy, mention can be made of pelvic inflammatory disease (Chlamydia trachomatis or Neisseria gonorrhea) and tubal surgery [17]
Summary
Ectopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility. The objective of this study was to evaluate the recurrence and fertility rate after salpingostomy in patients with tubal ectopic pregnancy. EP occurs in about 2% of pregnancies [2] and is one of the leading causes of pregnancy-related death [3, 4]. Poordast et al BMC Pregnancy and Childbirth (2022) 22:2. It may be asymptomatic, EP frequently presents with pain and vaginal bleeding in the first trimester of pregnancy [9, 10]; ,6-10% of patients present with ruptured EP and unstable hemodynamics [11]. Transvaginal sonography is a standard method for EP diagnosis [12], and the early detection owing to the improvements in this imaging modality has reduced mortality and morbidity [13]
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