Outcome of laparoscopic versus traditional surgery for ectopic pregnancies.

Overview

OBJECTIVE: To compare pregnancy rates after three surgical procedures for ectopic pregnancy (EP) over a 9-year period for normal and infertility patients. DESIGN: In a retrospective analysis, we examined crude pregnancy rates and life-table analysis of cumulative pregnancy rates. A proportional hazard regression model was used to examine relative risk of type of surgery and fertility rates. PATIENTS, PARTICIPANTS: One hundred twenty-six cases of EPs were reviewed at the Cleveland Clinic Foundation, a tertiary institution. MAIN OUTCOME MEASURES: Comparisons of rates of viable term deliveries were calculated between three types of surgery and were stratified according to the status of infertility. Confidence intervals for relative risk of surgery and fertility status on future pregnancy were calculated. RESULTS: No difference in pregnancy rates was observed after the three procedures (P = 0.08). Normals had a significantly higher (4 times higher) pregnancy rate than infertility patients, independent of surgical procedure. CONCLUSION: Successful pregnancy after EP is related to history of infertility rather than type of surgery to treat ectopic event. More randomized study is needed to examine laparoscopic salpingostomy, especially in patients with other infertility problems.