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Abstract
In a 16 year period at the University of Virginia Hospital, there were 189 proved cases of tubal pregnancy, for an incidence of 0.68 per cent or 1 in 149 deliveries. The mortality rate was 0.53 per cent. Cases in which laparotomy and colpotomy were performed because ectopic pregnancy was suspected totaled 437. Only 33 operations failed to disclose some abnormality.
Posterior colpotomy is a valuable diagnostic procedure when typical signs of ectopic pregnancy are absent. There should be no delay in visualizing and palpating the pelvic viscera when one suspects the condition; considering the disaster contingent upon failure to recognize it, one need not apologize for normal operative findings.
Abdominal or pelvic pain was the most consistent symptom, and pelvic tenderness the most reliable sign. An adnexal mass was noted at physical examination in only 102 of the 189 cases, and in 15 of these the tubal disease was discovered on the opposite side.