PROPHYLACTIC VASOPRESSIN DURING LAPAROSCOPIC SALPINGOTOMY FOR ECTOPICPREGNANCY

Study Objective. To evaluate the safety and efficacy of prophylactic m esosalpingeal vasopressin injection for hemostasis during laparoscopic salpingotomy for ectopic pregnancy. Design. Prospective, randomized c linical study. Setting. Reproductive endocrinology and endoscopic surg ery clinic of a tertiary care hospital. Patients. Forty women with ect opic pregnancy. Interventions. Laparoscopic linear salpingotomy was at tempted with prophylactic mesosalpingeal dilute vasopressin injection in 20 patients (study group), and without vasopressin in 20 patients ( control group). The two groups were similar with regard to age, size o i ectopic pregnancy, gestational age, and initial B-hCG values. A mult ipuncture operative laparoscopy technique was used in all cases and bi polar electrocoagulation was used for hemostasis. Measurements and Mai n Results. The operating time was significantly shorter and the need f or electrocoagulation was significantly less in the study than in the control group (p<0.05). Laparoscopic salpingotomy was performed succes sfully in 85% of study group patients compared with 70% of controls (p >0.05). Postoperative hysterogram revealed patency oi the affected tub e in 76.5% of women in the study group compared with 57.1% of controls (p>0.05). Possible complications of vasopressin, such as hypertension , bradycardia, and delayed bleeding, did not occur in any patient. Con clusions. Vasopressin use reduces both operating time and the need for electrocoagulation for hemostasis, which can have undesirable effects on the tube. Vasopressin was not associated with side effects in this relatively small sample.