pituitrin and Pregnancy--Tubal

To evaluate the safety and efficacy of prophylactic mesosalpingeal vasopressin injection for hemostasis during laparoscopic salpingotomy for ectopic pregnancy.. Prospective, randomized clinical study.. Reproductive endocrinology and endoscopic surgery clinic of a tertiary care hospital.. Forty women with ectopic pregnancy.. Laparoscopic linear salpingotomy was attempted, with prophylactic mesosalpingeal dilute vasopressin injection in 20 patients (study group), and without vasopressin in 20 patients (control group). The two groups were similar with regard to age, size of ectopic pregnancy, gestational age, and initial beta-hCG values. A multipuncture operative laparoscopy technique was used in all cases and bipolar electrocoagulation was used for hemostasis.. The operating time was significantly shorter and the need for electrocoagulation was significantly less in the study than in the control group (p <0.05). Laparoscopic salpingotomy was performed successfully in 85% of study group patients compared with 70% of controls (p >0.05). Postoperative hysterogram revealed patency of the affected tube in 76.5% of women in the study group compared with 57.1% of controls (p >0.05). Possible complications of vasopressin, such as hypertension, bradycardia, and delayed bleeding, did not occur in any patient.. Vasopressin use reduces both operating time and the need for electrocoagulation for hemostasis, which can have undesirable effects on the tube. Vasopressin was not associated with side effects in this relatively small sample.

Topics: Adult; Electrocoagulation; Fallopian Tubes; Female; Hemostasis, Surgical; Hemostatics; Humans; Laparoscopy; Pregnancy; Pregnancy, Tubal; Prospective Studies; Vasopressins

Topics: Adult; Chorionic Gonadotropin, beta Subunit, Human; Female; Gestational Age; Hemostasis, Endoscopic; Hemostatics; Humans; Laparoscopy; Postoperative Complications; Pregnancy; Pregnancy, Tubal; Treatment Outcome; Ultrasonography, Prenatal; Vasopressins

For better hemostasis in cases of operative pelviscopy in 60 patients Ornithine-8 Pitressin (POR 8) was applied locally as a vasoconstrictive agent in quantities of up to 50 ml at a concentration of 0.05 IU/ml. From the broad spectrum of indications for operative pelviscopy, the following procedures employing local application of a 5% POR 8 solution to produce intraoperative ischemia are described: Myoma enucleation, longitudinal salpingotomy with conception product extraction in the conservative treatment of a tubal pregnancy, ovarian cystectomy and salpingostomy. The tolerance was optimal no side effects were observed.

Topics: Endoscopy; Female; Hemostasis, Surgical; Humans; Leiomyoma; Ornipressin; Pregnancy; Pregnancy, Tubal; Salpingostomy; Uterine Neoplasms; Vasoconstrictor Agents; Vasopressins

Seventeen tubal pregnancies were treated successfully with a laparoscopic procedure over the past four years. Four different laparoscopic techniques were used: salpingectomy, partial salpingectomy (midtube resection), fimbrial expression, and salpingotomy. "Preventive hemostasis" using vasopressin has made salpingotomy our treatment method of choice. Ruptured tubal pregnancy was not considered a contraindication to laparoscopic treatment. Four of the six women who were trying to conceive and were followed for longer than six months have had documented intrauterine pregnancies; one woman subsequently developed a contralateral tubal pregnancy which was treated by laparoscopic salpingotomy. Tubal ectopic pregnancy, even in the presence of rupture, can be managed effectively by a variety of laparoscopic techniques with benefits including minimal incision, short hospitalization, early return to full activity, and in many cases, a patent tube.

Topics: Fallopian Tubes; Female; Hemostasis, Surgical; Humans; Laparoscopy; Methods; Pregnancy; Pregnancy, Tubal; Recurrence; Rupture, Spontaneous; Therapeutic Irrigation; Vasopressins

Topics: Dextrans; Edema; Fallopian Tubes; Felypressin; Female; Humans; Isotonic Solutions; Peritoneal Neoplasms; Postoperative Complications; Pregnancy; Pregnancy, Tubal; Sterilization, Reproductive; Therapeutic Irrigation; Tissue Adhesions; Vasopressins