Surgery

Surgery has been traditionally used both for the diagnosis and treatment of ectopic pregnancy. In the second half of the twentieth century laparoscopy was mostly used as a diagnostic tool and open surgery was used to treat ectopic pregnancy. With recent advances in operative laparoscopy, the minimally invasive approach has also become accepted as the method of choice to treat most tubal ectopic pregnancies. There are important advantages of laparoscopic over open surgery which include less post-operative pain, shorter hospital stay and faster resumption of social activity [30]. However, the future reproductive outcomes following laparoscopic or open surgery are not significantly different. Although the rate of recurrent ectopic is slightly lower following laparoscopic surgery, the rates of subsequent intrauterine pregnancies appear to be similar [31].

It remains unclear whether laparoscopic salpingotomy with tubal conservation offers any advantage over salp-ingectomy. Laparoscopic salpingotomy is usually a longer operation, with a higher risk of intraoperative and postoperative bleeding. In addition there is a 10-15% risk of persistent trophoblast following salpingotomy, which may require further surgical or medical treatment. However, data from observational studies indicate that tubal conservation results in slightly higher rates of subsequent intrauterine pregnancies [32]. Until this finding is tested in a prospective randomized trail the choice between removal of the tube and tubal conservation should be made depending on the circumstances in each individual case. At present there is a consensus that tubal conservation should be attempted if a woman desires further pregnancies and there is evidence of contralateral tubal damage at laparoscopy. In the presence of a healthy contralateral tube salpingectomy may be performed with the patient's consent [31].

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Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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