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

  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    Peter F. Lang
    Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    Affiliations
    Graz, Austria
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  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    Karl Tamussino
    Correspondence
    Reprint requests: Karl Tamussino, MD, Department of Obstetrics and Gynecology, University of Graz, Auenbruggerplatz 14, A-8036 Graz, Austria.
    Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    Affiliations
    Graz, Austria
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  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    Werner Hönigl
    Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    Affiliations
    Graz, Austria
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  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    George Ralph
    Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
    Affiliations
    Graz, Austria
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  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, University of Graz.
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      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 ≤ 2500 mil/ml and in six (60%) of 10 with an initial level >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 ≤ 2500 mlU/ml and > 2500 mill/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 chorionic gonadotropin level ≤ 2500 mlU/ml.

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