Premium
Ectopic pregnancy early diagnosis limitations
Author(s) -
Portuondo JoséA.,
Remacha María J.,
Llaguno Manuel Roldan
Publication year - 1982
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(82)90196-5
Subject(s) - medicine , ectopic pregnancy , obstetrics , pregnancy , abortion , pelvic inflammatory disease , laparoscopy , gestation , infertility , gynecology , surgery , genetics , biology
A series of 219 surgically and pathologic proven ectopic gestations are 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, PID, and abdominal surgery are often found in their past. Six per cent of patients had a previous ectopic pregnancy. Sixty‐one per cent of patients 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 first 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 β‐hCG pregnancy test, culdocentesis, ultrasound and laparoscopy, is finally proposed.