Diagnosis and management of tubal pregnancy: effect on fertility outcome.
We analysed 188 ectopic pregnancies seen during a 2-year period. They represented 2.2% of the live births that occurred during the same time interval. Overall, 53% of the tubal pregnancies had ruptured at the time of examination. Location was ampullary in 51% of the cases, isthmic in 28%, and 10% had aborted. Sixty-nine (38%) patients had an IUD. Diagnostic sensitivity was 58%-93% for pregnancy tests, 79% for culdocentesis, 41% for ultrasound examination, 43% for dilatation and curettage, and 100% for laparoscopy. Salpingectomy was performed in 47% of the cases, salpingotomy in 27%, and tubal resection in 19%. During a follow-up of 116 women (mean 1.5 years, range 0.5-3 years) 49% delivered, 10% had repeat ectopic pregnancy, 10% had abortion, 17% were infertile and 15% practised birth control. Among those who delivered no difference was found between those who underwent salpingectomy and those who underwent conservative surgery.
Paavonen
J
J
Varjonen-Toivonen
M
M
Komulainen
M
M
Heinonen
P K
PK
D000293:Adolescent; D000328:Adult; D003267:Contraception; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007743:Labor, Obstetric; D008722:Methods; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012008:Recurrence