The management of ectopic pregnancy

The current management of ectopic pregnancy in a main teaching hospital was reviewed in the lead up to the amalgamation of the services of three maternity hospitals. A retrospective analysis of 54 women treated surgically for suspected ectopic pregnancy from January 2005 to May 2006 was carried out. The diagnosis and management of ectopic pregnancy, including length of stay in hospital, was reviewed. Analysis revealed that 46% of women were treated laparoscopically, 28% underwent laparoscopy with subsequent conversion to laparotomy and 26% of women had a primary laparotomy, of which only half were clinically unstable. Inexperience in laparoscopic surgery was found to be the primary reason for conversion to laparotomy. As the majority of operations were performed by NCHDs, there is a need to increase the training received in laparoscopic surgery to reach an acceptable standard laparoscopic rate of greater than 90%. This would result in shorter lengths of stay in hospital, substantial financial savings and greater patient satisfaction.