A five-year review of ectopic pregnancy

During the five years from 1990-1994, 98 women underwent surgery for ectopic pregnancy. For every 167 deliveries, one patient underwent surgery for ectopic pregnancy. The incidence is 0.59 per cent with a rising trend. The commonest presenting symptom was abdominal pain (97%) followed by vaginal bleeding (79%). Four patients were asymptomatic and were diagnosed at routine antenatal ultrasound scan. The most frequent physical findings were abdominal tenderness (91%), followed by adnexal tenderness (54%). Histories of infertility (15%), use of intrauterine contraceptive devices (14%), and previous ectopic pregnancy (11%) were elicited. Five patients had a false negative urinary pregnancy test and subsequently required surgery. The ectopic pregnancies were tubal in 98 per cent of the cases. The diagnosis and management of ectopic pregnancy has changed significantly over the last decade. The increasing use of quantitative BHCG assay and vaginal ultrasonography have made early diagnosis possible, allowing conservative tubal surgery when indicated.