{"paper_id":"7e9620b3-7546-4941-8cf8-f9a4fc0124d9","body_text":"Abstract\nObjective: To identify risk factors for conversion to laparotomy during laparoscopic management of ectopic pregnancy. Methods: A retrospective chart review of patients who underwent laparoscopy for treatment of ectopic pregnancy, during a 32-month period (6/1999–2/2002), at the University of Miami Jackson Memorial Hospital. We identified 229 patients; 201 had a successful laparoscopy (non-converted group) and 28 who were converted to laparotomy (converted group).Variables analyzed between the two groups were demographic data, patient-related risk factors available to the surgeon prior to the surgery (previous laparotomy, previous laparoscopy, history of PID, history of endometriosis, diameter of ectopic pregnancy as measured by ultrasound, amount of free fluid on ultrasound, BMI), and surgeons’ experience. Results: Out of the 229 laparoscopies, 28 were converted to laparotomy (12.2%). The rate of conversion was significantly higher for less experienced compared to experienced surgeon (OR=6.1, 95% CI=2.35–15.88). Significantly more women had a BMI>30 kg/m2 in the converted group compared to the non-converted group (42% vs. 14%; OR=4.28, 95% CI=1.7–10.75) and the converted group had significantly higher rate of large free fluid reported on ultrasound compared to the non-converted group (21.42% vs. 7.46%; OR =3.38, 95% CI=1.04–10.61). Conclusion: Less experienced surgeon, BMI>30 kg/m2, and large amount of free fluid on ultrasound increase the risk of conversion to laparotomy during laparoscopic management of ectopic pregnancy.\nSimilar content being viewed by others\nReferences\nAkhan SE, Baysal B (2002) Laparotomy or laparoscopic surgery? Factors affecting the surgeons choice for the treatment of ectopic pregnancy. Arch Gynecol Obstet 266:79–82\nBarnhart K, Esposito M, Coutifaris C (2000) An update on the medical treatment of ectopic pregnancy. Obstet Gynecol Clin North Am 27:653–667\nCartwright PS, Herbert CM III, Maxson WS (1986) Operative laparoscopy for the management of tubal pregnancy. J Reprod Med 31:589–591\nEltabbakh GH, Piver MS, Hempling RE, Recio FO (1999) Laparoscopic surgery in obese women. Obstet Gynecol 94:704–708\nHsu S, Mitwally MF, Aly A, Al-Saleh M, Batt RE, Yeh J (2004) Laparoscopic management of tubal ectopic pregnancy in obese women. Fertil Steril 81:198–202\nMaruri F, Azziz R (1993) Laparoscopic surgery for ectopic pregnancies: technology assessment and public health implications. Fertil Steril 59:487–498\nMirhashemi R, Harlow BL, Ginsburg ES, Signorello LB, Berkowitz R, Feldman S (1998) Predicting risk of complications with gynecologic laparoscopic surgery. Obstet Gynecol 92:327–331\nMohamed H, Maiti S, Phillips G (2002) Laparoscopic management of ectopic pregnancy: a 5-year experience. J Obstet Gynaecol 22:411–414\nMurphy AA, Nager CW, Wujek JJ, Kettel LM, Torp VA, Chin HG (1992) Operative laparoscopy versus laparotomy for the management of ectopic pregnancy: a prospective trial. Fertil Steril 57:1180–1185\nPouly JL, Mahnes H, Mage G, Canis M, Bruhat MA (1986) Conservative laparoscopic treatment of 321 ectopic pregnancies. Fertil Steril 46:1093–1097\nShapiro HI, Adler DH (1973) Excision of an ectopic pregnancy through the laparoscope. Am J Obstet Gynecol 117:290–291\nSokol AI, Chuang K, Milad MP (2003) Risk factors for conversion to laparotomy during gynecologic laparoscopy. J Am Assoc Gynecol Laparosc 10:469–473\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nTakacs, P., Latchaw, G., Gaitan, L. et al. Risk factors for conversion to laparotomy during laparoscopic management of an ectopic pregnancy. Arch Gynecol Obstet 273, 32–34 (2005). https://doi.org/10.1007/s00404-005-0008-z\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-005-0008-z","source_license":"CC0","license_restricted":false}