|
|
|
| The influence of laparoscopic conservative surgery for treating women with tubal pregnancy on their postoperative intrauterine pregnancy |
| The First People's Hospital of Chuzhou, Anhui Province, 239001 |
|
|
|
Abstract To explore the clinical effect of laparoscopic conservative surgery for treating women with tubal pregnancy, and to study its influence on their postoperative intrauterine pregnancy. Methods: 80 women with tubal pregnancy who had fertility requirement were selected in this study. According to wishes of these women and the condition of their fallopian tube, 50 women in the study group were treated by laparoscopic conservative surgery and 30 women in the control group were treated by salpingectomy. The clinical effect of women were compared between the two groups, and the affect factors of their postoperative intrauterine pregnancy were analyzed. Results: The operation time and intraoperative blood loss of women in the study group were 47.3±5.5min and 43.6±5.2ml,which were significant higher than those (37.2±6.0min and 30.0±3.2ml) of the women in the control group, and the blood HCG turned to negative time of women in the study group was 18.4±2.6d, which was significant longer than that (9.26±3.87d) of the women in the control group (P＜0.05), but there were no significant different in the Foley catheter kept time, anal exhaust time, and postoperative hospital stay between the two groups (P＞0.05). In the study group, the results of postoperative lipiodol angiography showed that the rate of bilateral fallopian tube unobstructed was 60.0%, the rate of lesions fallopian tube unobstructed was 84.0%, and the rate of the contralateral fallopian tube unobstructed was 83.3%. There were no significant different in the intrauterine pregnancy rate, the ectopic pregnancy rate, and unpregnancy rate between the two groups (P＞0.05). There was no significant difference in the intrauterine pregnancy rate among women with different age, with lesions fallopian tube ruptured, with contralateral fallopian tube obstructed, or with the contralateral fallopian tube unobstructed (P＞0.05). There was significant difference in the intrauterine pregnancy rate among women with different HCG levels before operation, with pelvic adhesion, with ectopic pregnancy history, or with lesions fallopian tube unobstructed (P＜0.05). The univariate analysis showed that preoperative high HCG level, pelvic adhesion, and ectopic pregnancy history were the risk factors of intrauterine pregnancy later, but the contralateral fallopian tube unobstructed was the protect factor of intrauterine pregnancy later (P＜0.05). Conclusion: For women with mild pelvic adhesions and without recurrent ipsilateral tubal pregnancy, conservative laparoscopic surgery increases the operation time and intraoperative blood loss, but it can increase the intrauterine pregnancy rate. HCG levels > 2000IU/L before operation, ectopic pregnancy history, and severe pelvic adhesions are risk factors of postoperative intrauterine pregnancy.
|
|
|
|
|
|
|
|
|
