Laparoscopic management of recurrent ectopic pregnancy: A retrospective cohort study describing 10-years of experience in a tertiary care hospital

Abstract

Objective: Recurrent ectopic pregnancy (REP) is rare, but can have severe consequences for patients. The aim of this study was to report outcomes of laparoscopic management of REP in our center. Methods: Retrospective cohort study including REP treated surgically at a single, tertiary-care academic medical center between 2009 and 2018. All patients undergoing laparoscopic salpingostomy or salpingectomy were included. Patients were then followed up to monitor outcomes of future reproductive events. Results: Of 41 eligible patients, 14 suffered from ipsilateral recurrence including 5 cases of tubal stump pregnancy. In the other 27 cases, the REP occurred in the contralateral tube that was previously unaffected. All patients with ipsilateral recurrence underwent salpingectomy. In patients with contralateral recurrence, salpingectomy was carried out in 21 patients (77.8%) and salpingostomy in 6 patients (22.2%). 32 patients (78%) subsequently sought to conceive either spontaneously or by in vitro fertilization. The subsequent live birth rates were 51.8% (14/27) in the salpingectomy group and 60.0% (3/5) in the salpingostomy group. Conclusion: Where trained laparoscopists and adequate facilities are available, it is possible to achieve acceptable reproductive outcomes after REP irrespective of the surgical approach.

Keywords

• Recurrent ectopic pregnancy
• Salpingectomy
• Salpingostomy
• Reproductive outcomes