Laparoscopic instillation of hyperosmolar glucose vs. expectant management of tubal pregnancies with serum hCG < or = 2500 mIU/mL.

OBJECTIVE

To compare expectant management with local instillation of 50% glucose solution for tubal pregnancies with a serum hCG level < or = 2500 mIU/mL.

DESIGN

Prospective, non-randomized, comparative clinical study.

SETTING

Two university departments.

PATIENTS: One hundred and twenty-eight patients with laparoscopically-confirmed tubal pregnancy and serum hCG < or = 2500 mIU/mL.

INTERVENTIONS: Eighty patients in Graz were treated with laparoscopic instillation of 50% glucose solution and 48 patients in Turku were followed expectantly.

MAIN OUTCOME MEASURES: Resolution of hCG excretion, need for further interventions.

RESULTS

Seventy-four of the 80 patients (92%) in the glucose group (32 of 33 with an initial hCG < or = 250 mIU/mL and 42 of 47 with hCG 251-2500 mIU/mL) and 36 of 48 (75%) patients in the expectant group (19 of 23 with an initial hCG < or = 250 mIU/mL and 17 of 25 with hCG 251-2500 mIU/mL) had resolution of the pregnancy with no further intervention (p=0.008, chi-square test, odds ratio 0.24).

CONCLUSIONS

Glucose instillation is superior to expectant management for patients with early tubal pregnancy.