[Epidemiologic study of extra-uterine pregnancy. Apropos of 375 cases]

From a retrospective study over 11 years of 375 ectopic pregnancies, the authors have analyzed the epidemiological factors that could account for a very sensible and regular increase of the frequency of this gravidic accident. If a past history of tubal infection is usually considered as a major cause, in this series, we must mainly consider the abnormal frequency of the use of a modern contraceptive method at the time of the ectopic pregnancy, found in 32% of the cases. The place and the role of intra-uterine devices are discussed since a coil was associated with an ectopic pregnancy in 22.5% of the patients while the notion of a previous usage does not seem to be a predisposing factor: approximately only 2% of these patients had resorted to it. A hormonal contraception in progress may also lead to a late diagnosis, especially in patients using mini and micro-pills (8% of ectopic pregnancies). Finally, the advantages of conservative tubal surgery contingent on an earlier diagnosis are kept in mind by the authors because of the persistence of a high recurrence rate on the contralateral side, even after salpingectomy.