Background: Since 1970, incidence of ectopic pregnancy has increased nearly three-fold worldwide. Ectopic gestation is the most common cause of mortality associated with pregnancy in the first trimester, and may adversely affect subsequent fertility.
Methods: A total of 681 patients with ectopic pregnancies seen during a 12-year span were analyzed for clinical evaluations including etiology, diagnosis and therapy.
Results: The ratio of ectopic pregnancies to deliveries was 1:52. The largest figure occurring in multiparous patients was in the 26 to 30 year age bracket. A previous abdominal operation or previous antibiotic therapy substantiating antecedent pelvic inflammatory disease is a prime etiologic factor in ectopic pregnancy. The most significant physical finding was abdominal or rebounding tenderness associated with adnexal or cul-de-sac fullness. The diagnosis was initiated by urine beta-hCG (ELISA) or serum beta-hCG (RIA) and ultrasonography in the majority of patients. Nighty-three percent of ectopic pregnancies were tubal pregnancies, and therapy consisted primarily of total salpingectomy. There were no maternal deaths in this series.
Conclusions: Although newer diagnostic modalities are becoming more common, a correct diagnosis of ectopic pregnancy still relies heavily on clinical signs and symptoms. After a correct diagnosis is made, conservative surgical treatment or chemotherapy with preservation of the tube is the first choice for treatment. Thus to achieve a higher potential for a later pregnancy in the future for these women, routine salpingectomy should be the last resort.