Treatment of unruptured tubal pregnancy by laparoscopic instillation of hyperosmolar glucose solution

Abstract

Sixty patients with unruptured tubal pregnancy were treated with local laparoscopic instillation of 50% glucose solution. This treatment was successful in 49 (98%) of 50 patients with an initial serum human chorionic gonadotropin level of less than or equal to 2500 mU/ml and in six (60%) of 10 with an initial level greater than 2500 mU/ml. No side effects were seen. The average hospital stay of patients who did not require a second intervention was 5.2 days (range 3 to 10). The average time between glucose instillation and the decline of serum human chorionic gonadotropin levels below the level of detectability was 21.3 (+/- 14.3) and 30.2 (+/- 10.9) days in patients with serum levels less than or equal to 2500 mIU/ml and greater than 2500 mIU/ml, respectively. Five patients (8%) underwent a second laparoscopy (n = 4) or laparotomy (n = 1) because of stable or increasing human chorionic gonadotropin levels and progressing clinical symptoms. We conclude that laparoscopic instillation of hyperosmolar glucose solution is safe, technically simple, and effective in the treatment of unruptured tubal pregnancies associated with a serum human chronic gonadotropin level less than or equal to 2500 mIU/ml.