Lap Ectopic Pregnanacy
An ectopic pregnancy occurs when a fertilized egg implants itself outside of the uterus. They're also called "tubal pregnancies" because most of them happen in the fallopian tubes. Whether there's a problem with the egg or the tube, the egg gets stuck on its journey to the uterus.
A pregnancy can't survive outside of the uterus, so all ectopic pregnancies must end. It used to be that about 90% of women with ectopic pregnancies had to have surgery. Today, the number of surgeries is much lower, and many more ectopic pregnancies are managed with medication that prevents them from progressing.
If you're diagnosed with an ectopic pregnancy, how your doctor will treat it depends on how far the pregnancy has progressed, where the embryo is, and how severe your symptoms are.
An early ectopic pregnancy may be managed with medicine. If you have low levels of hCG -- a hormone your body makes when you're pregnant and there's no damage to the fallopian tube.
If medical therapy doesn't work, surgery is the next step. It's also the only option for women with high hCG levels, severe symptoms, and ruptured or damaged fallopian tubes.
You may have laparoscopic surgery that involves a very small cut, a tiny camera, and no damage to your fallopian tube. Surgeons prefer to use this method rather than doing surgery with a larger cut. But sometimes that's not possible. If your tube has ruptured or been severely damaged and you've had severe bleeding, you'll probably need emergency surgery with the bigger incision. In these situations, the surgeons might have to remove your fallopian tube.
The ectopic pregnancy is removed and the tube is either repaired (salpingostomy) or removed (salpingectomy).
Which procedure you have depends on the amount of bleeding and damage and whether the tube has ruptured.
Laparoscopy permits diagnosis and treatment to be combined in the same procedure and ectopic pregnancies can be diagnosed and treated at an early stage. In fact, laparoscopy is not only suitable for early ectopic pregnancies but it is also safe and feasible in instances where there is tubal rupture and hemoperitoneum, provided the patient is not severely compromised haemodynamically.
Laparoscopic approach was associated with shorter hospital stay and quicker postoperative recovery time. The subsequent intrauterine pregnancy rate was 70% after laparoscopic surgery compared to 55% after laparotomy. The recurrent ectopic rate was also lower after laparoscopy (5%) than after laparotomy (16. 6%).The laparoscopic approach is now the gold standard for treatment of ectopic pregnancy.