Laparoscopic management of tubal ectopic pregnancy in obese women

Objective: To study the surgical morbidity associated with the laparoscopic management of tubal ectopic pregnancy in an overweight population compared with a lean population. Design: Retrospective study. Setting: An academic tertiary referral obstetrics and gynecology center. Patient(s): One hundred seventeen patients in two groups, lean (n = 90; body mass index f less than or equal to 30) and obese (n = 27; body mass index >30) who had pathology-confirmed tubal ectopic pregnancies that were managed laparoscopically. Each group was subdivided into a laparoscopically managed group and a group in which laparoscopy was converted to laparotomy. Intervention(s): None. Main Outcome Measure(s): Operative time, blood loss, and complications of laparoscopic surgery as well as causes of conversion from laparoscopy to laparotomy, in obese compared with lean women, with ectopic pregnancy. Result(s): There was no significant difference in gestational age; beta-hCG level; or history of previous surgeries, ectopic pregnancy, pelvic inflammatory disease, or endometriosis or in any of the studied outcomes (conversion rate, blood loss, and operative time) between the lean and obese groups or their respective subgroups except for operative time between obese women who underwent laparotomy, which was significantly longer when compared with the case of lean women who underwent laparotomy. Intraoperative and postoperative complications were comparable between the lean and obese groups, and all complications occurred in the completed-laparoscopy group. Conclusion(s): Laparoscopic management of tubal ectopic pregnancy does not appear to significantly increase surgical morbidity in obese patients. (C) 2004 by American Society for Reproductive Medicine.)