[Change in tubal pregnancy 1983-1989. 7-years experiences with surgical laparoscopy]

The authors report on the changing aspects in diagnostics and surgical treatment of tubal pregnancy during a period of 7 years (1983-89). In that period, 432 cases of tubal pregnancy were diagnosed and treated, 311 of which were treated by endoscopic abdominal surgery. Diagnosis of tubal pregnancy now depends on radioimmunology for identifying the presence of beta-HCG in the serum as well as on sonographic diagnosis. This may supply proof of tubal pregnancy in many cases as early as 3-4 weeks after conception. Surgery should not be initiated too early, but should also not be too late. We found that the 4th to 5th week after conception yields the best results. During 1986-88, 156 patients were surgically treated by laparoscopy because of tubal pregnancy. These operations and the subsequent fate of the patients are analysed. 66 patients continued to actively wish for a child. In 15% of these there was a recurrence of tubal pregnancy. 62% of these patients became again pregnant in utero.