Treatment, failures and complications of ectopic pregnancy: changes over a 20 year period.
Data from all 225 women operated on for ectopic pregnancy in 1992-1994 at Sahlgrenska University Hospital were collected and compared with three previous cross-sectional investigations from our hospital (1975-1979, 1981-1982 and 1986-1987) in order to evaluate the extent to which surgical treatment and post-operative complications have changed over a 20 year period. Laparoscopic surgery, which was not possible in the 1970s, was used in almost 85% of the ectopic pregnancies in 1992-1994. Conservative treatment was still the most frequently used technique. The complication rate was 1.2% in 1975-1979 when only laparotomies were carried out. After the introduction of laparoscopic surgery (1986-1987), the complication rate rose significantly (7.3%) and continued to increase even when this procedure was established as routine (14.2% in 1992-1994). Post-operative complications were most frequent after conservative laparoscopic surgery (24.4%) while there were no complications after laparotomies. In spite of increasing complication rates the frequency of patients in pre-shock, as well as the proportion of patients with heavy intra-abdominal bleeding and tubal rupture, decreased over time.
Landström
G
G
Department of Obstetrics and Gynecology, Sahlgrenska Hospital, Göteborg University, Sweden.
Thorburn
J
J
Bryman
I
I
D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D019990:Perioperative Care; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013548:Sweden; D016896:Treatment Outcome