INCIDENCE OF PERIHEPATIC ADHESIONS IN ECTOPIC GESTATION

Objective: To compare the incidence of perihepatic adhesions in patien ts undergoing surgery for ectopic pregnancy with the incidence in pati ents undergoing elective laparoscopic sterilization. Fitz-Hugh-Curtis syndrome is a perihepatitis that usually occurs as a complication of p elvic inflammatory disease. Perihepatic adhesions may be an aftereffec t of the acute hepatic episode, and because the cause of ectopic gesta tion is thought to be salpingitis, women with an ectopic gestation may also have a higher prevalence of coexisting perihepatic adhesions. Me thods: We reviewed charts of 97 women who had undergone laparoscopy or laparotomy for ectopic pregnancy (study group) and 116 women who had laparoscopic sterilization (control group). We recorded all perihepati c, pelvic, or abdominal adhesions that were documented at the time of surgery. Medical histories and sites of adhesions in the two groups we re compared. Results: The incidence of perihepatic adhesions was 14% i n the study group compared with 3% in the control group (P < .01). For the total patient population, a history of pelvic infection correlate d positively with the presence of perihepatic adhesions (P < .01), and the study (ectopic) group had a higher incidence of previous pelvic i nfection. Conclusion: Compared with control subjects, significantly mo re women with ectopic pregnancies had perihepatic adhesions. In women who have history of pelvic infection or ectopic pregnancy, physicians should inquire about longterm right upper quadrant pain. The inclusion of lysis of perihepatic adhesions in the preoperative consent form ma y be useful. (Obstet Gynecol 1998;92:995-8. (C) 1998 by The American C ollege of Obstetricians and Gynecologists.).