[Risk of recurrence and rate of intrauterine pregnancy after endoscopic therapy of extrauterine pregnancies. 10 years experiences with the treatment of 709 extrauterine pregnancies]

Abstract

709 ectopic pregnancies were observed from 1983-1992 in the Department of Gynaecology of the Neukölln Hospital, Berlin, Germany, 585 out of which underwent laparoscopic treatment. 169 of 372 patients treated from 1986-1991 still wished to conceive, and we found intrauterine pregnancies in 60% (102 patients) and recurrent ectopic pregnancies in 27% (46 patients). In 9% (11 patients) of these the recurrence occurred following a delivery. A long term follow-up of patients from 1986-1988 was carried out in 1989 and 1993. Compared to 1989, the data of 1993 show a remarkable increase in recurrences and a merely slight increase in intrauterine pregnancies. For representative results the duration of follow-up should be 5 years or longer. 37 cases were operated on while preserving the organ, on a solitary tube or on both tubes. This group with an intrauterine pregnancy rate of 33-47% and a recurrence rate of 49% is discussed later. The risk of recurrence is increased after organ-preserving treatment of a second tubal pregnancy and after severe pelvic inflammatory disease. The process of deciding between maintaining the organ versus salpingectomy, is also discussed.