Abstract
Objective: We investigated reproductive outcomes after laparoscopic linear salpingotomy for isthmic tubal pregnancy.
Methods: From March 2000 to August 2011, we treated 19 cases of tubal isthmic pregnancy by conservative laparoscopic surgery consisting of salpingotomy with local injection of methotrexate (MTX).
Results: Sixteen cases (84%) were successfully treated, but 3 cases were converted to laparoscopic salpingectomy. Out of 16 cases, 2 (13%) were diagnosed with persistent ectopic pregnancy. Seven of 13 patients (54%) demonstrated patency of the treated tube by hysterosalpingography or second look laparoscopy. It was possible to evaluate subsequent fertility for 12 patients, 6 of whom obtained an intrauterine pregnancy and one who had a repeated ectopic pregnancy.
Conclusion: We propose that laparoscopic salpingotomy with local injection of MTX for isthmic pregnancy is suitable in selected cases, if careful management is offered.
