Laparoscopy Versus Laparotomy in Ectopic Pregnancy

Abstract

Background: Ectopic pregnancy (EP) is the implantation of fertilized ovum in any site of the reproductive tract except uterine cavity. To choose laparotomy or laparoscopy for treatment is based on the patient’s hemodynamic status, her past surgical history, and the physician’s experience in endoscopic surgery. The goal of this study was to compare clinical and laboratory findings in women who have undergone laparoscopy or laparotomy for EP.
Methods: In this cross-sectional study, 103 women, who had undergone laparoscopic or laparotomy treatment due to EP diagnosis, were enrolled. A structured questionnaire was used to collect information. Past fertility history, past medical and drug history, clinical symptoms and signs, laboratory findings (including Hb and serum β-hCG levels), size of EP mass and its location, endometrial thickness, free fluid in pelvic or abdominal cavity, type of treatment, and method were recorded.
Results: Of the study population, 58 had undergone laparotomy and 45 had undergone laparoscopy. Mean age, mass size, and B-hCG level before surgery were significantly higher in women who had undergone laparotomy. Right tubes followed by left tubes were the most affected sites. Unstable vital sign was recorded in the laparotomy group more than the laparoscopy group.
Conclusions: Results of the current study showed that women who had undergone laparotomy had significantly higher mean age, mass size, and B-hCG level and were more unstable than the laparoscopic group.