Ectopic pregnancy: a review of 147 cases

From July 1, 1972, to June 30, 1979, 149 patients with ectopic pregnancy were treated at Truman Medical Center. The history and physical findings, diagnostic procedures, etiologic factors and patient management were reviewed. Abdominal pain (98.6%), amenorrhea (74.1%) and irregular vaginal bleeding (56.4%) were the most common presenting symptoms. Abdominal tenderness (97.3%) and adnexal tenderness (98%) were the most common physical findings. Culdocentesis was performed in 118 cases and was positive for nonclotting blood in 94.1%. In 115 cases (78.2%) the ectopic pregnancy was ruptured prior to the time of admission. The incidence of diagnostic error was 35.9%. There were no maternal deaths; however, the incidence of morbidity was 26.5%. Our data reemphasize the need for a high degree of suspicion and early utilization of definitive diagnostic procedures if the morbidity and mortality of ectopic pregnancy are to be reduced.