Laparoscopic management of ectopic pregnancy

To assess the diagnostic process, laparoscopic treatment and postoperative period in patients hospitalized with a suspicion of ectopic pregnancy.

211 women who underwent a typical laparoscopic surgery due to ectopic pregnancy, from 1993 through to 2006, were included in the study. The diagnosis was based on the patient's history, gynecological examination, transvaginal ultrasound findings and beta hCG concentration.

The abnormal uterine bleeding was the most often reported symptom at admission (70.1%). The typical triad for ectopic pregnancy - amenorrhoea, abnormal bleeding and pain were present in only 55 patients (26%). The most frequent ultrasound findings were abnormal echogenic structures on the side of operated ectopic pregnancy (77.3%). 15.7% of women had no abnormalities described. The most frequent site of ectopic pregnancy implantation was the ampulla of the Fallopian tube (59.7%). Salpingectomy was performed in 53.5% of the cases, while salpingotomy in 35%. The postoperative period was generally uneventful in the majority of patients. There were only two cases that required a second surgery because of the worsening general clinical condition of the patient.

The ectopic pregnancy is currently diagnosed quite early and therefore can be treated with the use of endoscopic tools in a scheduled operation time. Nowadays, only a small percentage of women still require a sudden open surgery intervention.