Improved fertility following conservative surgical treatment of ectopic pregnancy

摘要: Objective To evaluate fertility after salpingectomy or tubotomy for ectopic pregnancy. Design Retrospective cohort study. Setting Clinical University Center, Hvidovre Hospital, Copenhagen. Population Two hundred and seventy-six women undergoing their first pregnancy between January 1992 1999 who actively attempted to conceive were followed a minimum of 18 months. Methods study combined with questionnaire compare reproductive outcome following pregnancy. Cummulative probabilities each group calculated by the Kaplan-Meier estimator compared Cox regression analysis control potential confounders. Main measures Intrauterine rates recurrence surgery pregnancy. Results The cumulative intrauterine rate was significantly higher (88%) than (66%) (log rank P < 0.05) correction confounding factors. No difference found in treatments (16%vs 17%). In patients contralateral tubal pathology, chance poor (hazard ratio 0.463) risk high 2.25), assessed regression. persistent 8%. Conclusion Conservative is superior radical at preserving fertility. not an increased repeat pregnancy, but which should be taken into account when deciding on operative procedure. Management case pathology disputed ideally addressed randomised clinical trial.