[Treatment of tubal pregnancy with prostaglandins: a multicenter study]

Abstract

In this prospective multi-centre-study, the new treatment of tubal pregnancies by means of local prostaglandin (PG) F2 alpha and systemic PG E2 application was compared to the usual surgical technique of eliminating the conceptus. In 71 patients treated with PG, the method proved to be successful in 81%; 21 patients (19%) required surgical intervention later. With an initial beta-hCG level of 2500 mIE/ml, the success rate increased to 88%. The duration of hospitalisation was significantly reduced in the PG group compared to the patients treated by primary operation (3 +/- 1 versus 6 +/- 2 days). In the PG-group, only 2 of 24 hysterosalpingograms showed tubal occlusions after treatment, whereas occlusion was present in 3 of 8 patients of the surgically treated group. Four subsequent intrauterine pregnancies in the PG-group occurred compared to none in the surgical group. PG treatment of tubal pregnancy in patients with a low initial beta-hCG value (less than 2500 mIE/ml) revealed promising results with regard to reduced postoperative morbidity and future fertility.

PIP: In this prospective, multicenter study, the new treatment of tubal pregnancies by means of local prostaglandin (PG) F2alpha and systemic PGE2 application was compared to the usual surgical technique of eliminating the conceptus. In 71 patients treated with PGs, the method proved to be successful in 81%; 21 patients (195) required surgical intervention at a later date. With an initial beta-hCG level of 2500 mIE/ml, the success rate increased to 88%. The duration of hospitalization was significantly reduced in the PG group compared to the patients treated by primary operation ()3 +or- 1 vs 6+or- 2 days). In the PG group, only 2 of 24 hysterosalpingograms showed tubal occlusions after treatment, whereas occlusion was present in 3 of 8 patients of the surgically treated group. 4 subsequent intrauterine pregnancies in the PG group occurred compared to none in the surgical group. PG treatment of tubal pregnancy in patients with a low initial beta-hCG value (2500 mIE/ml) revealed promising results with regard to reduced postoperative morbidity and future fertility. (author's)