Ectopic pregnancy: a five-year experience.

In the five-year period 1974 to 1978, there were 23,256 deliveries and 204 ectopic pregnancies at Fairfax Hospital. Forty-six patients (22.5%) had had previous pelvic surgery, including 14 salpingectomies for previous ectopic pregnancies. Only 27 patients (13.2%) had a history of salpingitis, but chronic salpingitis was evident in 91 patients (44.6%). Twenty-one patients (10.3%) had an IUD in situ at the time of diagnosis. Presenting symptoms included abdominal pain (95.1%), amenorrhea (73.7%), and abnormal uterine bleeding (63.7%). Abdominal pain (91.2%) and adnexal tenderness (94.6%) were the common pelvic findings. The correct diagnosis was made on admission in 77.5% of cases. Culdocenteses and pregnancy tests were positive in 82.4% and 81.2% of patients, respectively. Unilateral salpingectomy was the primary operative procedure in 78% of patients. Postoperative morbidity was limited almost exclusively to nonspecific fever (41.2%) and urinary tract infection (9.3%).