https://orcid.org/0000-0002-7171-1470
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Abstract
Background
The impact of various management plans on subsequent fertility after tubal ectopic pregnancy (EP) is not well known. The objective of the present study was an evaluation of the subsequent fertility outcome among women with EP managed either surgical or medical with systemic methotrexate or medical management followed by surgical one.
Patients and methods
A retrospective cohort study was done by reviewing of medical records of all women diagnosed with EP at King Faisal Military Hospital, Southern Region, Saudi Arabia throughout the period from January 2015 to December 2016 provided that they were hemodynamic stable, with starting βhCG level less than 10000 IU/L, and adnexal mass less than 5 cm. These cases were followed for four years from January 2017 to December 2020.
Results
The study included 85 women with EP. Their mean age was 31.3 ± 6.7 years. Medical management (systemic Methotrexate) was followed in 48.2% of cases whereas surgical management was applied for 43.5% of them while medical management followed by surgical one was seen in 8.2% of cases. Complete follow-up throughout 2017–2020 was available for 52 women. A history of recurrent EP was observed among 3 women (5.8%). Most of them (75%) had a viable pregnancy. There was no statistically significant association between the method of management of EP and subsequent fertility, although the rate of normal pregnancy (intrauterine viable pregnancy ≥ 24 weeks which is the age of viability at our hospital) was higher among those managed surgically or by medical followed by surgical management than those managed medical only (84.6% and 100% vs. 62.5%).
Conclusion
Although the normal pregnancy rate was higher among those managed surgically or by medical followed by surgical management than those managed medically only, this was not statistically significant.
Acknowledgements
The authors highly appreciate the support from King Faisal Military Hospital (Armed Forces Hospitals), Southern Region, Saudi Arabia for the outstanding support during the entire experiment.
Ethical approval
Approval of the regional Research and Ethics committee at King Faisal Military hospital (Armed forces Hospitals), Southern Region, Saudi Arabia was obtained prior to data collection.
Authors’ contributions
All authors had put the plan and collected the data.
Subject confidentiality
All reports, operative details and other records that leave the site would not comprise unique personal data to maintain subject confidentiality.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
Data available on request from the authors; The data that supports the findings of this study are available from the corresponding author, [Alanwar A.], upon reasonable request.