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Conservative Surgery for Ectopic Pregnancy

A Twenty-Year Review

From the Department of Obstetrics and Gynecology at the University of Minnesota Medical School, Minneapolis, Mn 55455

Abstract

Surgery for ectopic pregnancy need not be ablative. Early diagnosis based on the characteristic history, pelvic findings and diagnostic aids will permit surgical intervention in most patients before rupture occurs. Salpingotomy and other operative procedures are described which preserve the patient's reproductive capacity. In this 20-year review of 141 ectopic pregnancies, conservative surgery was performed in 24% during the first decade and in 53% during the last decade. Ectopic pregnancy recurred in 7 patients (all in the last 10*year series), 5 having had initial conservative surgery. Over the 20*year period of conservative surgery for ectopic pregnancy, 30 patients have had subsequent pregnancies; for a total of 32 viable births. Of 40 patients in whom conservative tubal operations were performed, five of the operations were successful; the contralateral tube had either been removed previously or was obstructed.