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Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy

OBJECTIVE: To compare the efficacy and safety between laparoscopy and local injection with absolute ethanol (AE) for treating tubal ectopic pregnancy (EP). STUDY DESIGN: Retrospective cohort study of ectopic pregnancies in the fallopian tube from two tertiary hospitals between January 2015 and Decem...

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Autores principales: Bi, Yin, She, Yuanping, Tian, Zhengping, Wei, Zhiyao, Huang, Qiuyan, Liao, Shengbin, Ye, Yuan, Qin, Aiping, Yang, Yihua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687442/
https://www.ncbi.nlm.nih.gov/pubmed/31403121
http://dx.doi.org/10.1016/j.eurox.2019.100032
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author Bi, Yin
She, Yuanping
Tian, Zhengping
Wei, Zhiyao
Huang, Qiuyan
Liao, Shengbin
Ye, Yuan
Qin, Aiping
Yang, Yihua
author_facet Bi, Yin
She, Yuanping
Tian, Zhengping
Wei, Zhiyao
Huang, Qiuyan
Liao, Shengbin
Ye, Yuan
Qin, Aiping
Yang, Yihua
author_sort Bi, Yin
collection PubMed
description OBJECTIVE: To compare the efficacy and safety between laparoscopy and local injection with absolute ethanol (AE) for treating tubal ectopic pregnancy (EP). STUDY DESIGN: Retrospective cohort study of ectopic pregnancies in the fallopian tube from two tertiary hospitals between January 2015 and December 2017. Clinical information such as presenting symptoms, reproductive history, possible risk factors, initial diagnosis, serum beta-human chor-ionic gonadotropin (β-HCG) level, transvaginal ultrasonography findings, methods of treatment and outcomes were reviewed and analyzed. RESULTS: A total of 119 patients were identified for this study. The diagnosis was based on clinical manifestations, ultrasonography scan and dynamic serum β-HCG. 71.4% of women (85/119) had at least one risk factor for ectopic pregnancy, with the most common risk factors being a history of induced labor, uterine curettage, spontaneous abortion or tubal pregnancy. 64 patients were managed by laparoscopic surgery (Group A) and 2 subjects were failure and followed by a systemic methotrexate (MTX) prescription. The other 55 patients had local injection with absolute ethanol, of which 9 cases failed, followed by a second local injection and intramuscular MTX. The HCG decrease rate post absolute ethanol injection was a value predictive factor for prognosis. Moreover, the pregnancy rate one-year post treatment in local injection subjects (10/55, 18.2%) was higher than that of surgical subjects (5/64, 7.8%). CONCLUSION: Local injection of absolute ethanol and laparoscopic surgery for tubal ectopic pregnancy are both effective and relatively safe, but laparoscopic surgery has better efficacy and shorten hospitalization day. Local injection may be less invasiveness and thus beneficial to fertility preservation.
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spelling pubmed-66874422019-08-09 Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy Bi, Yin She, Yuanping Tian, Zhengping Wei, Zhiyao Huang, Qiuyan Liao, Shengbin Ye, Yuan Qin, Aiping Yang, Yihua Eur J Obstet Gynecol Reprod Biol X Gynaecology OBJECTIVE: To compare the efficacy and safety between laparoscopy and local injection with absolute ethanol (AE) for treating tubal ectopic pregnancy (EP). STUDY DESIGN: Retrospective cohort study of ectopic pregnancies in the fallopian tube from two tertiary hospitals between January 2015 and December 2017. Clinical information such as presenting symptoms, reproductive history, possible risk factors, initial diagnosis, serum beta-human chor-ionic gonadotropin (β-HCG) level, transvaginal ultrasonography findings, methods of treatment and outcomes were reviewed and analyzed. RESULTS: A total of 119 patients were identified for this study. The diagnosis was based on clinical manifestations, ultrasonography scan and dynamic serum β-HCG. 71.4% of women (85/119) had at least one risk factor for ectopic pregnancy, with the most common risk factors being a history of induced labor, uterine curettage, spontaneous abortion or tubal pregnancy. 64 patients were managed by laparoscopic surgery (Group A) and 2 subjects were failure and followed by a systemic methotrexate (MTX) prescription. The other 55 patients had local injection with absolute ethanol, of which 9 cases failed, followed by a second local injection and intramuscular MTX. The HCG decrease rate post absolute ethanol injection was a value predictive factor for prognosis. Moreover, the pregnancy rate one-year post treatment in local injection subjects (10/55, 18.2%) was higher than that of surgical subjects (5/64, 7.8%). CONCLUSION: Local injection of absolute ethanol and laparoscopic surgery for tubal ectopic pregnancy are both effective and relatively safe, but laparoscopic surgery has better efficacy and shorten hospitalization day. Local injection may be less invasiveness and thus beneficial to fertility preservation. Elsevier 2019-04-30 /pmc/articles/PMC6687442/ /pubmed/31403121 http://dx.doi.org/10.1016/j.eurox.2019.100032 Text en © 2019 Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Gynaecology
Bi, Yin
She, Yuanping
Tian, Zhengping
Wei, Zhiyao
Huang, Qiuyan
Liao, Shengbin
Ye, Yuan
Qin, Aiping
Yang, Yihua
Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy
title Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy
title_full Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy
title_fullStr Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy
title_full_unstemmed Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy
title_short Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy
title_sort efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy
topic Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687442/
https://www.ncbi.nlm.nih.gov/pubmed/31403121
http://dx.doi.org/10.1016/j.eurox.2019.100032
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