[Changes in the diagnosis and therapy of extra-uterine pregnancy]

A total of 332 extrauterine pregnancies were treated between 1973 and 1975 (32) and between 1981 and 1987 (300). Of these, 195 (58.74% or of 300 = 65%) were operated on while employing endoscopy. The incidence of extrauterine pregnancy in relation to the total number of operations increased from 1.48% to 2.59%; in relation to the deliveries, the incidence rate increased from 0.99% to 4.15%. Diagnosis in an early stage where signs are only few, was made possible by specific determination of human chorionic gonadotropin in the urine (1981-1987: 84.1% positive) and by sonography (in 195 extrauterine pregnancies, 91.3% were found to be suspicious). Laparoscopic treatment, which has since become a standard method in extrauterine pregnancy, was possible in 45.7% of the cases in 1982 and in 89.9% of the patients in 1986. 11 relapses were seen after laparoscopic procedure while preserving the salpinges, whereas after laparotomy there were 20 recurrences. In four women intrauterine pregnancies became possible and were successful even after bilateral extrauterine pregnancy. In endoscopically conducted operations both the duration of anaesthesia and the postoperative course were clearly shortened, less associated with complications and subjectively easier for the patients. Complications were largely confined to repeated operations in cases where the pregnancy had not been fully removed, which could have been avoided (5.12%). Endoscopic treatment of extrauterine pregnancy is recommended.