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Laparoscopic management of 53 cases of cornual ectopic pregnancy.
Fertility and Sterility 2009 August
OBJECTIVE: To present our experience of laparoscopic management of cornual ectopic pregnancy.
DESIGN: Retrospective review of 53 cases of cornual pregnancy treated laparoscopically.
SETTING: K.K. Women's and Children's Hospital, Singapore.
PATIENT(S): Patients who were treated for cornual pregnancy via laparoscopic surgery from 2001 to 2006.
INTERVENTION(S): Laparoscopic surgery as a treatment modality for cornual pregnancy.
MAIN OUTCOME MEASURE(S): Success rate of laparoscopic surgery and future reproductive outcome.
RESULT(S): Fifty-two cases were managed by laparoscopy, and one was converted to laparotomy. Laparoscopic wedge resection was carried out in 33 patients, cornuostomy in 13 patients, and salpingectomy in 7 patients. Nine patients received methotrexate injection after surgery because of persistently high serum beta-hCG. Eighteen patients became pregnant, four had early miscarriages, and ten had pregnancies beyond 24 weeks' gestation. Five delivered vaginally, and three had cesarean section at term. Two patients traveled back to their native countries for delivery. There were no cases of uterine rupture or dehiscence reported.
CONCLUSION(S): Laparoscopic treatment of cornual pregnancy can be safely carried out with good results in an institution with trained laparoscopist and adequate facilities.
DESIGN: Retrospective review of 53 cases of cornual pregnancy treated laparoscopically.
SETTING: K.K. Women's and Children's Hospital, Singapore.
PATIENT(S): Patients who were treated for cornual pregnancy via laparoscopic surgery from 2001 to 2006.
INTERVENTION(S): Laparoscopic surgery as a treatment modality for cornual pregnancy.
MAIN OUTCOME MEASURE(S): Success rate of laparoscopic surgery and future reproductive outcome.
RESULT(S): Fifty-two cases were managed by laparoscopy, and one was converted to laparotomy. Laparoscopic wedge resection was carried out in 33 patients, cornuostomy in 13 patients, and salpingectomy in 7 patients. Nine patients received methotrexate injection after surgery because of persistently high serum beta-hCG. Eighteen patients became pregnant, four had early miscarriages, and ten had pregnancies beyond 24 weeks' gestation. Five delivered vaginally, and three had cesarean section at term. Two patients traveled back to their native countries for delivery. There were no cases of uterine rupture or dehiscence reported.
CONCLUSION(S): Laparoscopic treatment of cornual pregnancy can be safely carried out with good results in an institution with trained laparoscopist and adequate facilities.
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