Ectopic pregnancy early diagnosis limitations

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Abstract
A series of 219 surgically and pathologic proven ectopic gestations was reviewed to emphasize the ectopic pregnancy early diagnosis limitations. A childbearing-age, low-parity woman is typical of having an ectopic pregnancy. Risk factors in their past history were absent in 52% of patients. Fertility investigations, IUD [intrauterine devices], PID [pelvic inflammatory disease] and abdominal surgery are often found in their past. Patients (6%) had a previous ectopic pregnancy. Patients (61%) had a previous ectopic pregnancy. Patients (61%) were admitted with a definite ruptured ectopic pregnancy and 37% were admitted to rule out this condition. At surgery, 58% had ruptured ectopic pregnancy with intraabdominal hemorrhage. Only 12% were unruptured. The obstetric outcome after surgery was available in 74 patients. Out of these, 40.5% had term pregnancies with live children; repeat ectopic pregnancy occurred in 8.2% spontaneous 1st trimester abortion in 4.1% and subsequent infertility in 16%. Postoperative pelvic adhesions were more frequently seen, at laparoscopy, when the patients were diagnosed at the stage of ruptured ectopic pregnancy with intraabdominal hemorrhage. A diagnostic protocol based on the screening of the patients at risk, correct evaluation of symptom and signs and liberal use of .beta.-hCG [human chorionic gonadotropin] pregnancy test, culdocentesis, ultrasound and laparoscopy, is finally proposed.

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