Persistent ectopic pregnancy following laparoscopic linear salpingostomy

David B. Seifer, Jacqueline N. Gutmann, Michael B. Doyle, Ervin E. Jones, Michael P. Diamond, Alan H. Decherney

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

As the surgical approach for ectopic pregnancies evolves from radical to conservative procedures, the potential hazard of persistent ectopic pregnancy has become increasingly pertinent. From September 1, 1986 to August 31, 1989, 11 women with persistent ectopic pregnancy after laparoscopic salpingostomy were diagnosed and treated at Yale-New Haven Hospital. Persistent ectopic pregnancy was suspected in nine cases because of symptoms and in two because of plateauing /J-hCG titers. Ten of 11 patients underwent repeat surgery. Eight had partial or complete salpingectomy of the involved ipsilateral tube, two had repeat salpingostomies, and one was treated with methotrexate. When the 11 women with persistent ectopic pregnancies were compared with 70 patients treated successfully by laparoscopic salpingostomy using multivariate stepwise logistic regression, smaller size of the ectopic (P <.01) and fewer days of amenorrhea (P <.05) predicted persistent ectopic pregnancy after laparoscopic salpingostomy. Based upon our experience, we believe that earlier-treated ectopic pregnancies (ie, fewer than 42 days of amenorrhea) and/or smaller ectopics (ie, 2.0 cm or less in diameter) require treatment with particular caution and close postoperative surveillance.

Original languageEnglish (US)
Pages (from-to)1121-1125
Number of pages5
JournalObstetrics and gynecology
Volume76
Issue number6
StatePublished - Dec 1990

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Seifer, D. B., Gutmann, J. N., Doyle, M. B., Jones, E. E., Diamond, M. P., & Decherney, A. H. (1990). Persistent ectopic pregnancy following laparoscopic linear salpingostomy. Obstetrics and gynecology, 76(6), 1121-1125.