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pubmed:otherAbstract |
PIP: Injection of PGF2alpha intratubally, with other conservative management, was compared in 30 consecutive women with proven ectopic pregnancy, to 100 prior women treated surgically. The patient group were all 45 admitted after November 1987 to University of Vienna Hospital with suspected ectopic pregnancy, later proven in 30 by history, positive hCG, ultrasound and laparoscopy; the controls were 74 confirmed cases out of 101 suspected ectopic pregnancies admitted from January 1986- October 1987. They were treated with 5 or 10 mg PGF2alpha (Miniprostin F2alpha, Upjohn, Vienna), injected transabdominally with a 17-gauge needle, during laparoscopic visualization. In 6 patients, 2-3 mg Pgf2alpha was injected into the corpus luteum, but this practice was discontinued when 3 developed tachycardia, hypertension and extrasystole. 25 mg estrogen was injected into the ovary as a luteolytic subsequently. Most women also received PGE2 (Sulprostone, Schering, Berlin) twice daily im, although 4 could not tolerate side effects of nausea and vomiting. All women had hCG levels daily. 5 were treated by laparotomy because of rising hCG or clinical indications. In the control group 74 (73.3%) had laparotomy, and of these, 39 had total or partial salpingectomy, and 21 salpingotomy. Hysterosalpingography demonstrated tubal patency in 11 of 12 PG treated women tested to date; in contract, of 14 of the controls tested, none had patent tubes. 4 of the PG group have since conceived and delivered term infants. The benefits of this conservative method of treating ectopic pregnancy are apparent in the reduced morbidity, shorter hospital stay, simpler treatment technique, lower costs, and especially the higher rate of subsequent tubal patency and fertility.
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