Conservative Laparoscopic Surgery for Intramural Ectopic Pregnancy: A Summary of Twelve Case Reports

Abstract

Background: Intramural pregnancy (IMP) is a special type of ectopic pregnancy. The cause of the disorder nor a uniform effective treatment plan, either pharmacological or surgical treatment, has been reported. Pharmacological treatments have been associated with poor clinical outcomes and a higher risk of bleeding during treatment. Laparoscopic surgery for intramural pregnancy has been reported and timely diagnosis and early treatment by laparoscopy can reduce the adverse impact on female fertility. However, the safety and efficacy of laparoscopic treatment of intramural pregnancy has not been adequately evaluated. Methods: To evaluate the effectiveness of laparoscopic therapy of intramural pregnancy, we retrospectively selected clinical data from 12 patients with IMP treated by laparoscopy in our gynecology department (From January 2010 to December 2021). We collected clinical data from medical records, including: maternal age, gestational sac location, duration of amenorrhea, clinical symptoms, previous surgical history, pregnancy history, serum β-HCG (human chorionic gonadotropin) level, intraoperative bleeding and time of postoperative hospital stay. Results: All patients with intramural pregnancy who underwent laparoscopic surgery had their uterus preserved. Serum β-hCG decreased significantly after the operation and the average intraoperative blood loss was (50.9 ± 5.5) mL. The average length of stay was (5.4 ± 0.6) days resulting in an average hospital cost of 10,487 ± 548 RMB. Conclusions: Laparoscopic surgery is an effective and beneficial method for treating early intramural pregnancy preserving women’s uterus and protecting her future fertility.

Keywords

• intramural ectopic pregnancy
• laparoscopy
• hysteroscopy