A Clinical Evaluation of Laparoscopic Surgery for Tubal Pregnancy—the Usefulness of Intratubal Vasopressin and Methotrexate Administrations during Conservative Laparoscopic Surgery for Tubal pregnancy

Abstract

  We examined the clinical usefulness of intratubal vasopressin and methotrexate administration during conservative laparoscopic surgery for tubal pregnancy. A total of 49 patients who underwent conservative laparoscopic surgery for tubal pregnancy from January 2003 through December 2012 were enrolled in the study. All patients who had vasopressin and methotrexate (10 mg) injected into the tubal pregnancy during conservative laparoscopic surgery were treated by either a linear salpingostomy or fimbrial milking evacuation (removal of embryonic tissue alone). In 48 (98%) of 49 patients, the fallopian tubes were preserved by the conservative laparoscopic surgery, which included the intratubal injection of vasopressin and methotrexate. The incidence of persistent ectopic pregnancy was 0 (0%) of 50, and a recurrent ipsilateral tubal pregnancy was observed in 7% of 15 patients who achieved another pregnancy. The intratubal injection of vasopressin and methotrexate during conservative laparoscopic surgery for tubal pregnancy is a safe and more effective regimen for preservation of the fallopian tube as well as prevention of a persistent ectopic pregnancy.