Laparoscopy superior to laparotomy for managing ruptured tubal ectopic pregnancy
Ectopic pregnancy is one of the most emergency condition during the pregnancy period in which the fertilized egg implanted outside the uterine cavity. The occurrence of ectopic pregnancy accounts for approximately 2% of total pregnancy in worldwide, whereas in India the incidence is 3.5 to 7.1% and is a major cause of maternal morbidity and mortality with pregnancy loss. Most of the ectopic pregnancies are fallopian tube pregnancy and generally, the diagnosis happens after seven weeks of amenorrhoea with or without symptoms. Tubal rupture is sudden and life threatening emergency, which needs immediate attention.
Laparoscopy and Laparotomy both are established in gynaecology for several years. In the developed countries laparoscopy is widely used for management of ruptured ectopic pregnancy because of the availability of skilled manpower, logistics, improved anaesthesia and cardiovascular monitoring, well organised surgical care and good healthcare insurance. For ruptured tubal ectopic pregnancy management, Laparoscopic procedures implemented with an aim to reduce intra operative blood loss, analgesic requirements, hospital stay and higher recovery as well as it's effectiveness in patients with massive haemoperitonium. However, Laparotomy is still preferred surgery in low resource set ups.
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Dr. Nandita Mohan
BDS, MDS( Pedodontics and Preventive Dentistry)