• About Us
    • Contact Us
    • Login
    • ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
About Us Contact Us Login ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
Grand Rounds

Salpingectomy or Salpingostomy for the Management of Tubal Ectopic Pregnancy?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Mikhail et al. (Journal of Obstetrics and Gynaecology Research, 2018) describe the current trends surrounding ectopic pregnancy in the United states including:
    • Trends related to hospitalization
    • Patients’ characteristics
    • Surgical management

METHODS:

  • Retrospective, cross-sectional study
  • Participants: Patients treated for tubal ectopic pregnancy in an inpatient setting
  • Age 18-50 years
  • Data derived from the Nationwide Inpatient Sample databases
  • Primary outcomes associated with tubal ectopic pregnancy in US from 1998-2011
    • Frequency | prevalence | changes in inpatient surgical management rates

RESULTS:

  • There were 334,639 cases of ectopic pregnancies from among approximately 60 million maternal inpatient hospitalizations
  • The rate of tubal ectopic pregnancies decreased from 77.2 in 1998 to 40.5 in 2011 (per 10,000 maternal admissions)
  • The proportion of tubal ectopic pregnancies for which salpingostomy was performed decreased from 17.0% in 1998 to 7.0% in 2011
  • Rate of salpingectomy increased from 69.3% in 1998 to 80.9% in 2011
  • The temporal change in surgical choice was not related to differences in state IVF insurance mandates

CONCLUSION:

  • The rate of tubal ectopic pregnancies managed in inpatient settings decreased from 1998 to 2011
    • Unclear if due to increased medical management or true decline
  • The 82% rate of tubal ectopics found in this study was lower than the usual cited rate of 95% tubal out of all ectopic pregnancies
    • May be related to inpatient population used in this study
    • Non-tubal ectopics are more likely to be admitted
  • Salpingostomies declined while salpingectomies increased
    • Authors suggests that data overall supports an equal likelihood of intrauterine pregnancy and subsequent fertility with a healthy contralateral tube
    • Risks associated with salpingotomy include retained trophoblast tissue and repeat ectopic pregnancy
    • Salpingectomy may be preferred approach in most cases of tubal ectopic pregnancy
    • Consider salpingotomy in cases where
      • Contralateral tubal disease is present
      • There are infertility factors
      • Patient is of advanced reproductive age

Learn More – Primary Sources:

National rates, trends and determinants of inpatient surgical management of tubal ectopic pregnancy in the United States, 1998-2011.

image_pdfFavoriteLoadingFavorite

< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Diagnosing the Extrauterine Pregnancy-What You Need to Know
You’ve Diagnosed the Ectopic Pregnancy – When and How to Use the Medical Option
Disparities and the Management Patterns Over Time for Ectopic Pregnancy

Sections

  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • COVID-19

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site