Open v/s Minimal Invasive Surgery in Ruptured Ectopic Pregnancy

Abstract

Background: In some individuals, conservative surgical treatment is now effectively being replaced with methotrexate-based medical therapy. A woman's health is seriously jeopardized by ectopic pregnancy, which calls for immediate care and forceful early intervention. Even though laparoscopic surgery is thought to be the best course of action, Ruptured Ectopic Pregnancies (REP) is a frequent gynaecological emergency in places with limited resources, where laparoscopic surgery is the primary therapy. In the surgical care of women with REP, prospective randomized data combining laparoscopic procedures with laparotomy are lacking.

Objective:  To investigate the effects of open and minimally invasive surgeries on a woman's ability to get pregnant in the future after undergoing surgery for an ectopic pregnancy rupture.

Method: We looked at individuals who had salpingectomy and methotrexate treatment between 2010 and 2022. There were 21 cautious surgical operations performed between 1990 and 1995 (5.3% ectopic pregnancies). Ectopic births to normal births were 1:24. From 2010 to 2022, medical care was provided for 19 pregnancies (3.4% of ruptured deliveries).

Results: The ectopic birth rate at that time was 1:16.8. Patients receiving medicinal treatment were comparable to those receiving surgical treatment, with the exception that none were reported to have rebound discomfort, only 1/18 had an ultrasound scan that revealed a fatal heart, and none had a gestational sac larger than 4 cm.

Conclusion: In an environment with limited resources, operational laparoscopy for women undergoing treatment for REP is possible and has been linked to a considerable reduction in morbidity as well as a speedier return to economic activity.