Laparoscopie Conservative Management of Ectopic Pregnancy

Abstract

Ectopic pregnancy ( E.P. ) has became a surgical epidemic during the last decade. There is a five folds increase in hospitalization for E.P between 1970 to 1989 all over the world. E.P. remains an important direct cause of maternal deaths + accounting for 1 in 10 of all direct maternal deaths. The reasons for this internationally observed increase in E.P. are multiple, but can be attributed to better reporting, improved diagnostic tools and acquired risks for this disease in the reproductive population of women, the, most important risk factor is scarring of the pelvic viscera from previous infections. The classical therapy for tubal pregnancy has been the laparotomy and salpingectomy for decades. Because of infertility· problem caused by previous ectopic management and the organ new preserving philosophy. The treatment of E.P. no longer necessarily requires laparotomy. And the laparoscopic management is an efficacious, safe and cost effective approach for the resolution of E.P. problem. The standard history and physical examination remain insensitive methods for detecting E.P.; And there is no pathognomonic findings on examination that are diagnostic for E.P., So the diagnosis of E.P. as early as of 6-7 postmentrual weeks by screening of all suspected pregnancies may be the key for optimal use of new therapeutic concepts. VIS and Follow up of serum B-hCG levels are highly successful in early detection of intrauterine and ectopic pregnancy.