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

Emma Garcia Grau,Mário Oliveira,Judith Lleberia Juanós,Yolanda Canet Estevez,Miguel Ángel Checa Vizcaíno,Ramon Carreras Collado

doi:10.1155/2011/547946

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.

Highlights

Ectopic pregnancy (EP) is defined as the abnormal implantation of the blastocyst outside the uterine endometrium
Females with abnormal Fallopian tubes are at increased risk of developing an EP [3]
The aim of this study is to assess the usefulness of HSG following medical treatment of EP in order to counsel patients willing to have future gestations about the most appropriate method of conception

Summary

Introduction

Ectopic pregnancy (EP) is defined as the abnormal implantation of the blastocyst outside the uterine endometrium. The risk factors for developing EP include pelvic inflammatory disease (PID), history of EP, infertility, history of pelvic or abdominal surgery, endometriosis, sexually transmitted diseases, previous tubal surgery (namely tubal sterilization), smoking, older maternal age, and in uterus exposure to diethylstilbestrol. Some of these conditions result in scar tissue at the Fallopian tubes and may prevent the fertilized egg to reach the uterine cavity

Objectives

Methods

Results

Conclusion