If the patient is in stage II or stage III shock who has a large hemoperitoneum, laparotomy is the better choice. Acute abdomen in pregnancy represents a sure and advantageous approach - preferable - both for . There was no difference in hemodynamic status at presentation between the groups. Found inside â Page 380Bru hart reported the first laparoscopic surgery for ectopic pregnancy in 1980. LAPAROSCOPY VS LAPAROTOMY lN TREATMENT OF ECTOPIC PREGNANCIES El-Tabbakh reported the results of a trial in Kuwait from March 1999 to October 2001, ... (29) reported a frequency of second interventions of 8% in their laparoscopy group and zero in their laparotomy group. We concluded that laparoscopic treatment (salpingostomy or salpingectomy) of EPs offers major benefits superior to laparotomy in terms of less blood loss, less need for blood transfusion, less need for postoperative analgesia and a shorter duration of hospital stay. Laparotomy Vs Laparoscopy - Laparoscopy is reserved for pt who are hemodynamically stable. The selection of surgical approach (laparoscopy vs laparotomy) should be made by the surgeon in consultation with the anaesthetist and taking the clinical condition of the patient into account. Found inside â Page 148Surgical Treatment Surgical management of an ectopic pregnancy is indicated when medical therapy has failed or is ... the cul-de-sac and / or pelvis by transvaginal ultrasound Laparoscopy Vs. Laparotomy Conservative surgical treatment ... 1,2 Ec-topic pregnancy is responsible for a significant proportion of maternal mortalities in the United States, comprising about 9% of all such deaths. Accessibility Leach RE, Ory SJ. Treatment of ectopic pregnancy in 2000. In fact, it actually saves time, as during a laparotomy, opening and closing the abdomen just to gain access to the affected tube consumes precious operating time. The Kuwait study led the author to conclude that laparoscopy treatment offered benefits superior to laparotomy with less blood loss, therefore, a reduced need for transfusion. Results. The choice today is Laparoscopic treatment of unruptured ectopic pregnancy. Post-operative management followed the normal practice in both departments. Found inside â Page 409A similar study was published by Vermesh et al51 who prospectively randomized patients with unruptured ectopic pregnancy to either laparoscopy or laparotomy , and subsequently analyzed pregnancy rates , tubal patency by ... Antifungal Resistance in Vulvovaginal Candidiasis (VVC) Infections, Alternative Treatment Options, Consortium for Sexual Health and Wellness, Enhanced Recovery for Cesarean Delivery: Perspectives From the Front Lines, Part 2, Podcast: Next Generation Carrier Screening for Genetic Diseases, Rationale for a New Method of Contraception. We had no cases amongst the 201 patients who had conservative surgery on the tubes (in both groups), with persistent trophoblastic tissues after surgery. Sixty women were diagnosed with ruptured ectopic . If the bleeding has ceased or can be arrested adequately, rupture tubal pregnancies can be treated successfully endoscopically. One hundred eighty-four were treated by laparoscopy and 23 by laparotomy of the 207 patients with a diagnosis of ectopic pregnancy based . June 27, 2011. All patients had the ectopic pregnancy confirmed by laparoscopy and the decision to proceed with operative laparoscopy or laparotomy depended on the minimal invasive surgery experience of the surgeon on call. Hemodynamic instability; Massive hemoperitoneum; Ruptured ectopic pregnancy. Any condition that prevents or retard migration of fertilized ovum to the uterine cavity could predispose a woman to an ectopic gestation. Takeda A, Manabe S, Mitsui T, Nakamura H. J Minim Invasive Gynecol. There was no difference in hemodynamic status at presentation between the groups. Results During 1996-1999 a total of 118 cases had been . Method: In this prospective study there were 207 with a confirmed EP at Hadi Hospital and El-Rashed Hospital, private hospitals in Kuwait. Median operating time was significantly shorter in the laparoscopy group (50 minutes [range, 43-63 minutes] vs 60 minutes [range, 60-72 minutes]; The study showed that 40% of EP was ruptured at the time of presentation. As the surgeons gain more experience and training with laparoscopic surgery for ectopic pregnancy, it has become the preferred choice when equipment and resources were available. Found inside â Page 143Laparoscopy vs laparotomy Conservative surgical treatment via operative laparoscopy is generally preferred to ... outcomes between laparoscopy and laparotomy for the treatment of ectopic pregnancy show similar rates of subsequent tubal ... 3. Excision of an ectopic pregnancy through the laparoscope. Two embryos did not implant into the womb. Chlamydia may be asymptomatic and untreated as well as other infectious agents associated with an increased risk of salpingitis and potential tubal damage. The author concluded that while it was more expensive than laparotomy. It is well documented that in developing countries, minimal research has been done in this gynecologic emergency as in the African region [14]. There are limitations to laparoscopy. Adhesion or other pathologic processes such as endometriosis can be treated simultaneously during removal of ectopic pregnancy without significantly prolonging the operation. 594/3041 (19.5%) patients developed complications: higher among laparotomy patients (37.3%) compared to laparoscopy (14.7%), P<.01 & among salpingectomy (20.0%) compared to salpingostomy (17.6%), P=.2. MMWR 1992; 41:591-4. This is a new edition of one of the modern classics of gynecological surgery. [1].Sepilian V,Ectopic Pregnancy.Emedicine, 2003; [2].Seeber BE,Barmhart KT,Suspected Ectopic Pregnancy.Obstet Gynecol 2006; 107:399-413, [3].Burhart,M.A,Mahens H,Magee,E,Poultry, J.L,Treatment of Ectopic Pregnancy by means of Laparoscopy.Fertil Strile,1980;33:411-414, [4].El-Tabbakh .MN, ElsaysMS,Ubal Ectopic Pregnancy; Laparoscopy vs Laparotomy www.Obgyn.Net/Pregnancy-Birth/Page/Pb/Articles/El-Tabbakh-Tubel-Ectopic, [5].Xiang,XD,Tane,YQ,Mao,J.F.A Comparison of Laparoscopic Surgery and Laparotomy in the Treatment of Ectopic Pregnancy. Norwich: Stationery Office, 1998. Sixty women were diagnosed with ruptured ectopic pregnancy and massive hemoperitoneum: 48 underwent emergency laparoscopy; 12 underwent emergency laparotomy. Providing rapid solutions to the most difficult problems posed by ectopic pregnancy, the focus throughout this study is on diagnosis and management issues. Early diagnosis is the key to less invasive treatment. Unable to load your collection due to an error, Unable to load your delegates due to an error. (13). Leke, R.J., Goyaux, Matsuda, Et al. In the studies reviewed, the results favoured a laparoscopic approach Clasen et al presented 293 cases that were treated surgically. Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial. Ankum WM, Hajenius PJ, Schrevel LS, van der Veen F. Management of suspected ectopic pregnancy. Delayed diagnosis and subsequent deaths are important findings that should encourage African gynecologists to promote ectopic pregnancy. To compare the safety and feasibility of operative laparoscopy versus laparotomy in women with ruptured ectopic pregnancy and massive hemoperitoneum. This site needs JavaScript to work properly. Although the majority (96%) of EP cases have fallopian tube localisation 1••], other potential areas include the cervix . A teaching hospital experience. Seeber also stated that these symptoms may be erratic and variable , and in some cases, absent. METHODS: A retrospective chart review of patients who underwent laparoscopy for treatment of ectopic pregnancy, during a 32-month period (6/1999-2/2002), at the University of Miami Jackson Memorial Hospital. Arch Gynecol Obstet 2000 Feb;263(3):87-92. Seven hundred and six were treated by laparoscopy and 634 by laparotomy. [16]. All laparoscopic procedures were performed by the first author at Hadi hospital and the second author at El-Rashed hospital. 3. Authors R Baumann 1 . The estimated blood loss was significantly less in the laparoscopy group. Smoking may alter tubal and uterine motility, and is associated with a risk of 1.6-3.5 times more than non smokers. There were 3 maternal deaths from ectopic pregnancy with a mortality rate of 0.94%. Median operating time was significantly shorter in the laparoscopy group (50minutes [range, 43-63minutes] vs 60minutes [range, 60-72minutes]; P=0.01). Identification of the bleeding point followed by careful bipolar electro desiccation. Laparoscopic management of interstitial pregnancy. Impact of new diagnostic tool in 686 consecutive cases. There was no difference between the groups regarding gestational duration, size and location of the ectopic gestation, or the mean preoperative hCG values. Ghosh S, Mann C, Khan K, Gupta JK. If the pregnancy is interstitial it may be associated with traumatic rupture, hemorrhagic shock and there is two fold increase in maternal mortality over other tubal pregnancies. 1 The accurate diagnosis of ectopic pregnancy can now be made at an . Among those attempted laparoscopically, only two had to undergo a laparotomy because of failure of the laparoscopic approach. Linear salpengotomy was performed. The main purpose of this book is to address some important issues related to gynecologic laparoscopy. [10]. Prospective comparison of videopelviscopy with laparotomy for ectopic pregnancy. Three laparotomy cases were primary and 5 were converted from laparoscopy [14]There were 14 cases with residual disease that were treated either by methotrexate or a second operative procedure. Operative laparoscopy is currently the best treatment for EP (8).The benefits to patients are self-evident and our findings are supported in the literature.Â. Objective: J Gynecol Obstet Biol Reprod (Paris) 2000 Jun;29(4):351-61. Objectives: To compare the efficiency of laparoscopic treatment versus conventional abdominal surgery in the treatment of ectopic pregnancy (EP) and to review the clinical presentation, evaluate methods of diagnosis, and identifying the risk factors. Why have I been offered this treatment? Offers guidance on the use of ultrasonography in a clinical setting, covering benign and malignant gynecological disease and infertility. While the mode of surgery should be based on the surgeon's experience and preference, the significantly lower hemoperitoneum volume associated with laparoscopy may be a reflection of shorter operating times and quicker . Br J Obstet Gynaecol 1991; 98:765. In a retrospective cohort study at a university-affiliated medical center, records of women with ruptured ectopic pregnancy and massive hemoperitoneum (> 800 mL) were reviewed. Fertil Steril 1993; 59:487. The patients experienced less need for analgesia, and a shortened postoperative hospitalization [4]. Sepilian reported that approximately 20% of ectopic patients are hemodynamically unstable at initial presentation suggesting a ruptured ectopic gestation. Estimated blood loss was significantly lower in the laparoscopy group (P<0.0001). Modern management of ectopic pregnancy. The study aims to compare laparotomy with laparoscopy in this group of women with regards to outcomes such as length of hospital stay, number of days off work and pain. Ectopic pregnancy in Abha, Saudi Arabia. Brumsted el al reported on a comparison of laparoscopy and laparotomy for the treatment of ectopic pregnancy at the University of Vermont between 1982 and 1987 involving 101cases. 23. Age, gravida, parity, previous history of spontaneous loss and previous MTP were having no significance in selection of laparoscopic and laparotomy procedure. The differences between laparoscopy and laparotomy cases and the factors which directed the surgeon to choose either of the surgical methods were evaluated. Lancet 1998; 351: 1115-1120. Pisarska MD, Carson SA, Buster JE. A Comparison of Laparoscopy and Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-analysis. Controlling bleeding is the most critical part of the procedure, and several methods can be attempted sequentially to achieve haemostasis: After successfully managing the ectopic pregnancy laparoscopically, the patient can be discharged second day. The cumulative frequency of hCG elimination down to the non pregnant level (<20 IU/l) was similar in both groups.Â. The duration of operation in laparoscopy group was 66.46±19.97 min and 72.52±20.01 min in the laparotomy group and the difference between the durations of operations was not considered to be significant. Salpingectomy with or without corneal resection and in some difficult cases hysterectomy may be necessary. INTRODUCTION. 2021 Sep 10;71:102840. doi: 10.1016/j.amsu.2021.102840. This randomised study will be conducted at Kalafong hospital, on 140 patients diagnosed with ruptured ectopic pregnancy who are haemodynamically stable and are able and willing to provide informed consent. et al (1989) Obstet Gynecol 73:400,1989 - 60 patients with . Ectopic Pregnancy usually occurs of cases on the uterine tube. After thorough evaluation, type of management was decided. Results. Ectopic pregnancy in Africa: A population based study. Pak J Med Sci. Seeber stated that the symptoms of abdominal pain or pelvic pain and vaginal bleeding are the most common complaints suggestive of ectopic pregnancy, The multiple potential sites of ectopic pregnancies add to the complexity of the diagnosis. OBSTETRIC INDICATION Ectopic pregnancy Heterotopic pregnancy Excision of Rudimentary Horn . In the present study we have demonstrated that EPs can be managed successfully via minimal access surgery and Laparoscopic management offer several advantages over conventional treatment via laparotomy (table 2). (9)(27)(28). If the gynaecologists are not careful there may be a chance of adjacent visceral injury. In a retrospective cohort study at a . It is important to remain aware of the location of underlying or adjacent structures. Found inside â Page 274Cesarean section scar is managed by wedge resection of the ectopic pregnancy via laparotomy, laparoscopy, or hysteroscopy. Ultrasound-guided aspiration of the gestation sac with or without local injection of potassium chloride or ... [1]. A review and comments. The duration of hospitalization was significantly shorter in the laparoscopy group (P<0.0001). 1,2 Ec-topic pregnancy is responsible for a significant proportion of maternal mortalities in the United States, comprising about 9% of all such deaths. Int. Careful monitoring and proper counselling of patients is mandatory. Liskin Ls, Maternal morbidity in developing countries. Sepilian stated that ectopic pregnancy is derived from the Greek word "ektopos" meaning out of place, and it refers to the implantation of the fertilized ovum in a location outside of the uterine cavity including the fallopian tubes, cornual or interstitial region of the uterus and fallopian tubes, cervix, ovary, and the abdominal cavity. A randomized trial versus laparotomy Acta Obstet Gynecol Scand. New options for diagnosis and treatment of ectopic pregnancy. The results reported by Brumsted et al at the conclusion of the study demonstrated less operating time for the laparoscopy-treated group. Group 1 consisted of 56 patients with operative laparoscopy and Group 2 consisted of 61 patients treated by laparotomy. quantitative β-hCG was 2000 iu/ml. The operating time and post operative hospitalization were shortened. 10. After surgery, to detect persistent viable trophoblastic tissue all patients were followed up by serial serum B-hCG levels on day 4 and day 7 and then weekly until non-pregnant levels (< 20 IU/l) were reached. To compare the safety and feasibility of operative laparoscopy versus laparotomy in women with ruptured ectopic pregnancy and massive hemoperitoneum. A rare case of non-iatrogenic bilateral ectopic pregnancy (two-tailed tubal ectopic pregnancy) case report. Follow up is necessary because of the possibility of persistent trophoblastic tissue in the fallopian tube. This difference may be related to the fact that most Kuwaiti women are regularly attendants for antenatal care starting in very early pregnancy and they are keen to do early B hCG and transvaginal sonography. History and physical examination alone do not reliably diagnose or exclude EP, as up to 9% of women report no pain and 36% lack adnexal tenderness (8). Ovarian cyst—Some women have cysts that develop on the ovaries. It also became evident that the use of the laparoscopic approach is generally the most appropriate even in the presence of rupture, provided the patient is . Lehner R, Kucera E, Jirecek S, Egarter C, Husslein P. Ectopic pregnancy. Methods. A continuing conundrum. A 10 mm suction instrument is used to clean the abdominal cavity. Conventional versus Single Port Laparoscopy for the Surgical Treatment of Ectopic Pregnancy: A Meta-Analysis. All patients underwent diagnostic laparoscopy. Removal of pregnancy within the tube using laparoscopic keyhole surgery. In the present study laparoscopic techniques (salpingostomy or salpingectomy) do not increase the operating time. 25. The pregnancy was removed with a forceps, the tube was irrigated with lactated Ringer's solution and haemostasis was achieved with bipolar diathermy. PMC Brumsted J,Kessler C,Gibson C,Nakajima S,Riddick DH,Gibson M.A comparison of laparoscopy and laparotomy for the treatment of ectopic pregnancy.Obstet Gynecol 1988;71:889-92. A laparoscopy is when a small tube with a camera is put into the stomach area to collect a tissue sample for testing. Failure of the laparoscopic approach because in one case it was not possible to achieve pneumoperitoneum because of extreme obesity. Upon urgent diagnostic laparoscopy, massive hemoperitoneum was detected . This clinically oriented text presents a wide range of endoscopic approaches to pelvic pathologies, including operative laparoscopic resection of ectopic pregnancy, new treatments of pelvic inflammatory diseases, anesthesia pertinent to ... If the tissue is bulky and can not be accommodated through cannula, endobag can be used for retrieval of tissue. Obstet Gynecol 1989; 73: 400-403. Lundorff P, Thorburn J, Lindblom B. To compare the safety and feasibility of operative laparoscopy versus laparotomy in women with ruptured ectopic pregnancy and massive hemoperitoneum. The formation of shadisation postoperatively has been more extensive with laparotomy. 2019 Dec;18(4):222-226. doi: 10.5114/pm.2019.93115. - Ruptured Ectopic does not necessarily require Laparotomy, but if large clots are present Laparotomy should be considered. © 2021 MJH Life Sciences⢠and Contemporary OB/GYN. Epub 2020 Jan 15. Cornual pregnancies generally require a laparotomy and surgical excision (31); although cases have been successfully managed via the laparoscope (32).Â, Our study confirm this. Reproductive outcome Is similar in pt treated with either Laparoscopy or Laparotomy. Bruhart et al reported the first laparoscopic surgery for ectopic pregnancy in 1980 [3]. Authors Peter . Keywords: Although the incidence of EP increased, with the improvement of diagnostic approaches, patients were detected at an earlier stage and possible to be treated more conservatively.(7). Int J Gynaecol Obstet 1994; 46: 331-332. vs . J. Gynecol Obstet 1999; 66; 179-80. Total salpingectomy is performed by progressively coagulating and cutting the mesosalpinx, beginning with the proximal portion to fimbrial end. Al Dus G, Alhamoud AU, Ata Allah N, Alabdalla J. Ann Med Surg (Lond). The study aims to compare laparotomy with laparoscopy in this group of women with regards to outcomes such as length of hospital stay, number of days off work and pain. (6).Â, This prospective clinical trial was conducted to compare the efficiency of laparoscopic treatment versus conventional abdominal surgery for tubal ectopic pregnancy and to review the clinical presentation, evaluate methods of diagnosis, and identifying the risk factors.Â. In a retrospective cohort study at a university-affiliated medical center, records of women with ruptured ectopic pregnancy and massive hemoperitoneum (> 800 mL) were reviewed. Those not trained in operative laparoscopy proceeded to perform a laparotomy. Laparoscopy was mostly performed for tubal abortion (40%) and unruptured ectopic pregnancy (25%) whereas laparotomy mostly for ruptured ectopic pregnancy (70%). Conclusion: laparoscopic treatment (salpingostomy or salpingectomy) of EPs offers major benefits superior to laparotomy in terms of less blood loss, less need for blood transfusion, less need for postoperative analgesia and a shorter duration of hospital stay. 2015 Dec;39(12):2862-71. doi: 10.1007/s00268-015-3212-4. Management of ectopic pregnancy. Sixty-one were treated by laparoscopy and 44 by laparotomy. Tubal Ectopic Pregnancy: Laparoscopy vs. Laparotomy. (26) (33). Half litre of lactated Ringer's solution was left in the pelvis at the conclusion of the operation to help prevent adhesion formation (12). World Laparoscopy HospitalCyber City, Gurugram, NCR Delhi INDIA : +919811416838World Laparoscopy Training InstituteBld.No: 27, DHCC, Dubai UAE : +971523961806World Laparoscopy Training Institute8320 Inv Dr, Tallahassee, Florida USA : +1 321 250 7653, Paid Online Consultation From Our Surgeon. Ectopic pregnancy and anesthesia in Gambia. Blood transfusion was required by 13% in the laparoscopically treated group compared to 23% in the laparotomy group [4]. unruptured EP<5cm undergoing salpingostomy - shorter hospital stay-1.4d vs 3.3 average saving $1500 - less blood loss in laparoscopy group - quicker return to activities - postop. The case study was a 36-year-old gravida 2 para 0 patient, previously normal pregnant lady, in which the follow-up ultrasound revealed moderate hemoperitoneum at 14-16 weeks of gestation. J Coll Physicians Surg Pak. Sepelian wrote that the classic triad of amenorrhea, pain, and vaginal bleeding has been strongly associated with the clinical presentation of ectopic pregnancy, however, 50% of patients with ectopic pregnancy present without this triad. This complication of early pregnancy, results in not only fetal loss, but also the potential for considerable maternal morbidity and the risk of maternal death (2)(3)(4). Currently, laparoscopic surgery is . Ectopic pregnancy is still a very common and possibly increasing problem among healthy young women [15].That 40,100 live births occurred in the same city during the same time that the incidence of ectopic pregnancy was 0.79%, the authors concluded that the country was under reported. If the affected tube is conserved, the patient should be followed by serial hCG estimations until these return to normal. [18]. Keywords: laparoscopic surgery, ectopic pregnancy, laparoscopy, salpingostomy, salpingectomy. DR. RAY L. GREEN; MD, FACOG, D.MAS; DR. R.K. MISHRA; M.S; M.MAS; MRCS; Ph.D. A review of studies comparing laparoscopy versus laparotomy for the treatment of ectopic pregnancy. Clasen's study in Belgium included 285 ectopic pregnancy patients treated by laparoscopy of the 1,363. In one week the beta hcg should return to baseline i.e. Other factors associated with an increased risk of ectopic pregnancies include prior abdominal surgery, a ruptured appendix, exposure to diethylstilbesterol and uterine developmental abnormalities. In another study of 142 patients in China, Xiang reported the results of a comparison of laparoscopy surgery and laparotomy in the treatment of ectopic pregnancy. Most (58%) of our patients were within the 21-32 age group. Women who undergone salpingectomy will have a risk of subsequent ectopic pregnancy in the remaining tube [2]. The frequency of EP in our series was 1.1%.In Abha, Saudi Arabia the incidence of EP was 0.74 per 100 live births (16). 4. Ectopic pregnancy. Sixty women were diagnosed with ruptured ectopic pregnancy and massive hemoperitoneum: 48 underwent emergency laparoscopy; 12 underwent emergency laparotomy. Paper presented in the third world conference in Fallopian tube in health and disease,1990;July 3-6,Kiel, Germany. Reproductive outcome Is similar in pt treated with either Laparoscopy or Laparotomy. 12. The incidence of ectopic pregnancy in Africa may have increased in recent times [15]. About 64% of ectopic pregnancies occur in the ampulla where fertilization occurs. The cumulative frequency of hCG elimination down to the non pregnant level (<20 IU/l) was similar in both groups (Fig 1).Â, Discussion The technical advancement in the field of minimal access surgery has greatly enhanced the possibility of both diagnosing and treating EP effectively. Results: Median operating time was significantly shorter in the laparoscopy group (50 minutes [range, 43-63 minutes] vs 60 minutes [range, 60-72 minutes]; Laparoscopy became the primary approach for the management of ectopic pregnancy in part because of resident participation in an ongoing laparoscopy training program. Surgical treatments may be radical (salpingectomy) or conservative (usually salpingostomy), and they may be performed by laparoscopy or laparotomy (9). In the present study The most important symptoms were abdominal pain (96%), short period of amenorrhea (89.1%) and vaginal bleeding (79%). The average time taken for the B-hCG to return to normal (<20 IU/l) was 12 days after conservative surgery in both groups. It is a surgical procedure (a laparoscopy) performed under a general anaesthetic to remove the ectopic pregnancy. Ectopic pregnancy is a major cause of maternal morbidity and mortality, increasing in incidence worldwide. Laparotomy operation is simple, can clearly reveal operation field, and is currently the most widely used way of ectopic pregnancy emergency surgery,.Laparoscopic surgery is the operation method rising in recent years, the endoscopic equipment enables . Feng W, Cao B, Li Q. Found inside â Page 218Table9.4.3: ComparativeResultsofConservativeOperations for Tubal Pregnancy by Laparotomy and Laparoscopy ... The ideal marker for ectopic pregnancy would be specific for tubaldamage or presentonlyafterendometrial implantation. The mesosalpinx if bleed should also be cauterized by using bipolar forceps, particular attention given to the arcuate anatomizing branches of the ovarian and uterine arteries. The decision to perform salpingostomy is opposed to salpingectomy is often made intra operatively. When an ectopic pregnancy is located in an enraptured fallopian tube, every attempt is made to remove the pregnancy without removing or . All pregnancies conceived within 6 months after surgery. There were no significant differences in age, parity or gestational age. We identified 229 patients; 201 had a successful laparoscopy (non . Li Y, Xiang Y, Wu N, Wu L, Yu Z, Zhang M, Wang M, Jiang J, Li Y. Eric I. Archibong, Adekunle A. Sobande. Salpingectomy was the commonest . More than three-quarters of women who experience ectopic pregnancy should to be treated surgically . Am J Obstet Gynecol 1987; 157: 618-622.
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