A prospective series of unruptured ectopic pregnancies treated by tubal injection with hyperosmolar glucose.

Abstract

OBJECTIVE:

To evaluate the safety and efficacy of hyperosmolar glucose injection in select unruptured tubal gestations with hCG levels less than 2500 mIU/mL.

METHODS:

In this prospective series, 16 patients with an hCG titer less than 2500 mIU/mL and an unruptured ectopic pregnancy were treated by tubal injection with hyperosmolar (50%) glucose. Hyperosmolar glucose was injected transabdominally into the antimesenteric site of the tubal pregnancy, using a 20-gauge spinal needle. The main outcome measures evaluated were duration of surgery, success rate, time to resolution, and follow-up tubal patency rates.

RESULTS:

Ninety-four percent (15) of the subjects were treated successfully with a median time to resolution of 24 days (range 5-78). The one treatment failure required methotrexate because of rising hCG titers and worsening pain 4 days after the patient was treated with hyperosmolar glucose. The mean (+/- standard error) duration of surgery was 45 +/- 6 minutes. So far, all ten patients undergoing postoperative hysterosalpingograms have demonstrated tubal patency in the treated tube.

CONCLUSION:

Laparoscopic injection with hyperosmolar glucose is an effective, systemically nontoxic alternative treatment for select unruptured ectopic pregnancies (hCG less than 2500 mIU/mL) that achieves tubal patency rates comparable to other conservative medical and surgical treatments.

• Authors: T R Yeko, J C Mayer, A K Parsons, G B Maroulis
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 85 Issue 2 Pg. 265-8 (Feb 1995) ISSN: 0029-7844 [Print] United States
• PMID: 7824243 (Publication Type: Journal Article)

Chemical References

• Chorionic Gonadotropin
• Glucose
• Methotrexate

Topics

• Chorionic Gonadotropin (blood)
• Fallopian Tube Patency Tests
• Female
• Glucose (administration & dosage)
• Humans
• Injections
• Laparoscopy
• Methotrexate (therapeutic use)
• Osmolar Concentration
• Pregnancy
• Pregnancy, Tubal (blood, therapy)
• Prospective Studies