Management of ectopic pregnancy by laparotomy and subsequent fertility

Abstract

Introduction During the past two decades, there has been a profound change in the approach to diagnosis and treatment of ectopic pregnancies. In developed countries, the use of transvaginal ultrasonography together with the measurement of beta-hCG facilitate early diagnosis of ectopic pregnancies, and conservative treatment can be carried out by laparotomy or by laparoscopy in the majority of cases before significant tubal distortion or rupture. It is important to emphasise that laparoscopic treatment of ectopic pregnancy (EP) depends on the development of appropriate technology and training in laparoscopic surgery. In developing countries, this method is not yet routine. The purpose of this paper is to evaluate the outcome of the treatment of EP by laparotomy in our unit where facilities for laparoscopic surgery are not available. Attention is focused on the stage at diagnosis, intraoperative complications and subsequent fertility.