Clinical Analysis on Laparoscopic Diagnosis and Treatment of Early Atypical Tubal Pregnancy / 中国微创外科杂志

ABSTRACT

Objective To explore the diagnostic and therapeutic effects of laparoscopy for early atypical tubal pregnancy.Methods Laparoscopy was conducted for diagnosing and treating 38 cases of early or atypical tubal pregnancy.For patients with blue and purple pregnant swellings seen clearly in the fallopian tubes,or those with one side of fallopian tube locally swollen and purple without obvious pregnant swellings observed,combination of fallopian tubes incision to take out embryo and salpingorrhaphy was performed.For those cases with normal fallopian tubes on both sides in appearance and without current desire of pregnancy,diagnostic uterine curettage was applied.After the diagnosis of tubal pregnancy was confirmed,30 mg of MTX was injected into ampulla of both sides.For patients with demand of reproduction,diagnostic uterine curettage was not performed.Results Five cases were misdiagnosed before operation,the misdiagnosis rate was 13%.Three cases were misdiagnosed by laparoscopy,and the rate was 8%.Fallopian tubes incision for embryo-taking under laparoscope combined with salpingorrhaphy were applied to 30 cases.Four cases were treated conservatively with injecting 30 mg of MTX into the fallopian tubes.The success rate was 100%.Blood ?-hCG was back to the normal level(4.2?3.1)days after surgery.Conclusions Laparoscopy is the optimal technique for the diagnosis and treatment of early atypical tubal pregnancy.