LAPAROSCOPIC THERAPY FOR TUBAL PREGNANCY USING PROSTAGLANDINS

Nineteen patients with confirmed tubal pregnancy and constant or risin g plasma beta-human chorionic gonadotropin (beta-hCG) levels were trea ted with laparoscopically guided injection of prostaglandin F2alpha in to the oviduct. Fifteen patients received additional prostaglandin E2 during three consecutive postoperative days. One patient was excluded from the study. The treatment was defined as successful when plasma be ta-hCG levels declined below the lower detection limit and no further intervention other than prostaglandin application was required. The tr eatment was successful in 12 patients (66.7%). Given a beta-hCG level greater than 2,500 mU/mL as an exclusion criterion for treatment with prostaglandin, the success rate was 84.6%. Six patients underwent salp ingotomy because of rising beta-hCG levels following treatment. The ou tcome was not related to the postoperative treatment with prostaglandi n E2. None of the treated patients displayed any adverse reactions fol lowing prostaglandin F2alpha application. Postoperative hysterosalping ography was performed on six successfully treated patients, demonstrat ing bilaterally patent fallopian tubes in all of them. Prostaglandin t herapy in tubal pregnancy has been proven effective in selected cases.