Predictors of subsequent pregnancy in women who underwent laparoscopic cornuostomy or laparoscopic wedge resection for interstitial pregnancy.

Chen, Pei-Ling; Lin, Ho-Hsiung; Hsiao, Sheng-Mou

BACKGROUND The ideal surgical procedure for interstitial pregnancy remains undetermined. The aim of this study was to assess whether surgical method is a factor in predicting subsequent pregnancy in women with interstitial pregnancy who underwent laparoscopic cornuostomy or laparoscopic wedge resection. METHODS Medical records of all women with interstitial pregnancy who underwent laparoscopic cornuostomy or laparoscopic wedge resection between March 2008 and October 2017 in a medical center were reviewed. Cox regression analysis was performed to identify factors predicting subsequent pregnancy. RESULTS Forty patients underwent laparoscopic cornuostomy (n = 14) or laparoscopic wedge resection (n = 26) for the treatment of interstitial pregnancy. Twelve women become pregnant during follow-up. Laparoscopic cornuostomy was associated with shorter operation time (coefficient = -19.1 minutes, 95% CI = -36.9 to -1.3 minutes, p = 0.04, multivariable analysis) than that of laparoscopic wedge resection. Furthermore, laparoscopic cornuostomy (hazard ratio = 6.3, p = 0.03), parity (hazard ratio = 0.18, p = 0.008), and preoperative rupture of the cornus (hazard ratio = 13.3, p = 0.005) were independent predictors of subsequent pregnancy. CONCLUSION Laparoscopic cornuostomy was associated with a higher probability of subsequent pregnancy and a shorter operation time. Thus, compared with laparoscopic wedge resection, laparoscopic cornuostomy might be a better surgical procedure for women with interstitial pregnancy, particularly for women who wish to become pregnant later. However, because of the retrospective nature and small sample size of this study, some well-defined/designed prospective studies including more patients are needed to verify our results.