Fertility after ectopic pregnancy

Ectopic pregnancy: a nursing approach to excess risk among minority women

Ectopic pregnancy rates have quadrupled during the last decade. Although maternal mortality has been reduced for white women, largely because of rapid pregnancy testing and improved ultrasonography, the death rate for minority women is almost twice that of white women, and minority adolescents are almost five times as likely to die of ectopic pregnancy. In this article, causative factors are identified, and the potential for race, gender, and age bias in diagnosis and treatment is discussed. Involvement by nurses in preventive programs, clinical research, and advocacy for policy change may help reduce ectopic pregnancy mortality rates.

Intrauterine pregnancy in a patient with a sole remaining tube after local treatment of tubal pregnancy with hyperosmolar glucose

A spontaneous IUP occurred 8 months after laparoscopic instillation of hyperosmolar glucose solution into a tubal pregnancy in a patient with a sole remaining tube. This is the first unequivocal proof of intact tubal function after treatment of a tubal pregnancy with local hyperosmolar glucose.

Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial

OBJECTIVE

To evaluate the fertility outcome after laparoscopic surgery for ectopic pregnancy.

DESIGN

A randomized trial versus laparotomy was performed between May 1987 and June 1989.

SETTING

The study was conducted in a clinical university center, the Sahlgrens Hospital.

PATIENTS

A group of 105 patients with tubal pregnancy were stratified with regard to risk determinants and age and randomized to laparoscopy or laparotomy. Eighty-seven patients who desired pregnancy were evaluated for subsequent fertility outcome.

INTERVENTIONS

Linear salpingotomy was performed in both surgical groups.

MAIN OUTCOME MEASURE

We evaluated the fertility outcome after laparoscopic salpingotomy for comparison with the outcome after laparotomy.

RESULTS

There was no difference between the groups in the overall fertility outcome. A substantially higher proportion of patients in the laparotomy group were subjected to adhesiolysis performed at a second-look laparoscopy.

CONCLUSIONS

The fertility prospects are not impaired by laparoscopic surgery. Adhesiolysis at a second-look laparoscopy, especially after laparotomy, might be beneficial in selected cases and may serve to improve subsequent fertility.