E. Kemmann et al., CAN WE PREDICT PATIENTS AT RISK FOR PERSISTENT ECTOPIC PREGNANCY AFTER LAPAROSCOPIC SALPINGOTOMY, The Journal of the American Association of Gynecologic Laparoscopists, 1(2), 1994, pp. 122-126
To identify factors that may predict patients at increased risk for pe
rsistent ectopic pregnancy after linear salpingotomy, we analyzed demo
graphic, surgical, and biochemical variables retrospectively in 60 wom
en who underwent laparoscopic linear salpingotomy, and compared data i
n those who developed persistent ectopic pregnancy (study group) versu
s those who were cured (controls). The two groups were similar with re
spect to demographic features and surgical findings. They did not diff
er significantly in gestational age and human chorionic gonadotropin (
hCG) levels at time of surgery. There was, however, a significant diff
erence in hCG dynamics when the average daily increase in the week bef
ore surgery was analyzed. Eleven (18%) women developed persistent ecto
pic pregnancy. The disorder did not occur in those whose hCG levels we
re flat or declining, whereas patients whose levels increased more tha
n 40% per day had a significantly greater risk. In addition, at surger
y, tubal bleeding was significantly more common in study patients than
in controls (55 vs 9%, p <0.001). We conclude that hCG dynamics in th
e week before salpingotomy, and bleeding activity at surgery may ident
ify patients who are the most likely candidates for persistent ectopic
pregnancy.