Comparison the results of hysterosalpangiography in patients with ectopic pregnancy treated by laparoscopic salpingostomy, laparotomy, and treated with methotrexate

Abstract

Background: Ectopic pregnancy (EP) occurs in 1% of pregnancies, and may seriously effects on women's health and future fertility so this study aimed to compare the results of hysterosalpingography (HSG) after treatment of EP by laparoscopy, laparotomy, and methotrexate (MTX) therapy. Materials and Methods: This was a clinical trial study was done on 112 EP women with treatment indication referred to Isfahan Al-Zahran and Shahid Beheshti Hospitals from 2017 to 2018. They were divided into 33 populated groups of laparoscopic salpingostomy, laparotomy and MTX. Then patients of three groups underwent HSG 3 months after intervention. The factors such beta human chorionic gonadotropin (β–hCG) (mIU/mL), size of EP (mm), infection, hospital length of stay (LOS), and tubal patency were recorded and compared between the groups. Results: There were no significant differences between groups for age, body mass index, β–hCG, Size of EP, and hospital LOS (P > 0.05). The infection was more frequent in laparotomy group with no significant difference among three groups. The infection rates were 9%, 12%, and 6% for MTX, laparotomy, and laparoscopy arms, respectively. Between the three groups tubal patency as primary outcome had higher frequency than laparoscopy group, although, the difference was not statistically significant (P = 0.595). Conclusion: Although infection was more in laparotomy and that tubal patency was more within 3 months in laparoscopy and MTX, there were no statistically significant differences in the results of laparoscopy, laparotomy, and MTX in HSG results.

Keywords

• ectopic pregnancy
• hysterosalpangiography
• laparoscopy
• salpingostomy
• laparotomy
• methotrexate