Evaluation of Fallopian Tube by Hystrosalpingography or Laparoscopy after Medical Treatment of Ectopic Pregnancy

Background: Ectopic pregnancy is a serious cause of tubal loss or dysfunction among women in the reproductive age. Medical treatment is a commonly prescribed management under certain circumstances. It is associated with a high success rate, but tubal affection is a result. Objective: Assessment of fallopian tubes following medical treatment of ectopic pregnancy in order to advise individuals who wish to have future pregnancies on the most appropriate technique of conception. Methods: This prospective randomized clinical trial was conducted at Al- Hussein Hospital, Al Azhar University Hospitals and Al Sahel Teaching Hospital from June 2021 until June 2022 on 60 women with history of the previous ectopic pregnancy treated by medical treatment and divided into 2 equal groups; 30 of them were evaluated using hysterosalpingiography and other 30 using laparoscopy. Results: About two thirds of studied cases had normal tubes after medical treatment. In hysterosalpingography group; 19 (63.33%) cases had normal tubes, 6 (20%) cases had unilateral patency, 3 (10%) cases had bilateral obstruction and 2 (6.67%) cases had patency with alteration. On the other hand, In laparoscopy group; 20 (66.67%) cases had normal tubes, 5 (16.67%) cases had unilateral patency, 2 (6.67%) cases had bilateral obstruction and 3 (10%) cases had patency with alteration. Intramuscular route of methotrexate was noted to be the most effective one compared with US -guided and laparoscopic intrasacular injections but with no statistical significant difference. Conclusion: Medical treatment is safe effective and noninvasive option for management of ectopic pregnancy as about two thirds of studied cases still had normal tubes after medical treatment.