Ectopic Pregnancy in the United States

Seventy-two patients with repeat ectopic pregnancy including 3 women with three ectopic pregnancies each during the period 1965 to 1984 were studied. In the same period there was a total of 842 ectopic pregnancies, giving a repeat ectopic pregnancy incidence of 9.4%. In the last decade the incidence of repeat ectopic pregnancy was 10.4%, and in the first decade it was 7.0% (p less than 0.025). None of the women used an intra-uterine contraceptive device, among those with repeat ectopic pregnancy in the first decade, vis-à-vis 17 (30.4%) in the last decade. A history of infertility was common among the patients with repeat ectopic pregnancy. Between the two events there was a total of 17 deliveries in 13 patients. Four out of 24 potentially fertile women completed full-term pregnancies following their second ectopic pregnancy.

Section: Discussionsupporting

confidence: 92%

Repeat Ectopic Pregnancy: A Twenty‐year Hospital Survey

Sandvei

Bergsjø

Ulstein

et al. 1987

“…ec,topic pregnancy is still a potentially lifethreaten.ing condition. The incidence varies in different publications (6)(7)(8)(9) but EP amounts to about one in ten cases of first trimester complications, i.e. 90/n in a recent British study (9) and 1 0 %~ in ours.…”

Section: Discussionmentioning

confidence: 49%

“…Of a total of 525 patients with a positive urinary hCG test, 57 underwent laparoscopy according to the above protocol. Their mean age was 31 years (range 23-43) and duration of amenorrhoea 6.5 weeks (4)(5)(6)(7)(8)(9)(10)(11)(12). The presenting complaints were pain and vaginal bleeding in 44 patients, pain only in 12 and vaginal bleeding only in one.…”

Section: Resultsmentioning

confidence: 99%

Transvaginal sonography in the management of ectopic pregnancy

Sadek¹,

Schiøtz²

1995

During a 3-year period, 525 women referred to our department with abdominal pain and/or vaginal bleeding in the first trimester of pregnancy were evaluated by transvaginal sonography. Ectopic pregnancy was suspected and laparoscopy done when sonography showed an empty uterus or pseudosac together with free pelvic fluid and/or a tubal mass. Fifty-seven patients fulfilled these criteriae. Among these patients, sonography showed an empty uterus in 48, pseudosac in five, a non-diagnostic intrauterine echo in four, a tubal mass in 45 and free pelvic fluid in 54. Laparoscopy confirmed ectopic pregnancy in 53 patients (93.0%). There were only five tubal ruptures. Pelvic blood was found in all of the 54 patients with free fluid on sonography; i.e. in 51 of 53 patients with ectopic pregnancy and in three with miscarriage. Forty-nine patients with ectopic pregnancy were managed by laparoscopy and four by laparotomy. All were hemodynamically stable. The diagnostic sensitivity and specificity of vaginal sonography for ectopic pregnancy was 96.2% and 99.4%, respectively, for the finding of free pelvic fluid, and 81.1% and 99.6% for a tubal mass. All patients with ectopic pregnancy were correctly selected for laparoscopic management. Transvaginal sonography is a valuable tool in the early diagnosis of ectopic pregnancy.

“…Ectopic gestation affects an appreciable proportion of the fertile population. Although the incidence varies in different publications, it has been steadily increasing in recent years (1,2,3). The annual maternal mortality rate from ectopic pregnancy has declined over time, but other causes have fallen more rapidly (2).…”

mentioning

confidence: 99%

Treatment of tubal pregnancy by laparoscopic laser surgery

Langebrekke

Kirschner

Skår

et al. 1991

We present 150 consecutive cases of tubal pregnancy treated by laparoscopic techniques. A three-puncture technique was used. 74 cases were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases were treated nonconservatively through the laparoscope by salpingectomy or tubal resection. Contra-indications to laparoscopic surgery were haemodynamically unstable patient and interstitial pregnancy. Seventy-five per cent of all tubal pregnancies were treated by laparoscopy in the period studied. No complications were encountered during the laparoscopic operations. Two patients needed a second laparoscopy, while 2 others underwent a subsequent laparotomy. This study has shown that tubal ectopic pregnancies can in most cases be effectively managed by laparoscopic techniques.