Extrauterine pregnancy
Saarikoski, S.
Duodecim; Laaketieteellinen Aikakauskirja 101(15): 1475-1480
1985
ISSN/ISBN: 0012-7183 PMID: 3899598 Document Number: 254015
The diagnostic possibilities for extrauterine pregnancy have improved of late. Whether the perceived increase in such pregnancies during recent years is due to improved diagnostics, or to an actual increase in such pregnancies is not known. Many studies have been conducted in Finland and other countries: (Savolainen and Saksela, 1987; Westron et al, 1961, Rubin et al, 1983; Gummerus and Saari-Kemppainen, 1984). The number of extrauterine pregnancies has doubled in the last few years; in Finnish hospitals they occur in approximately 2% of all births. The following are possible causes: The IUD is known to multiply the number of intrauterine infections 2-9 times. Laparoscopy is another risk factor, as is abdominal surgery. (Thorburn et al, 1986, found that 50% of all patients with extrauterine pregnancies had had abdominal surgery). Ovarian surgery seems especially harmful, so that surgical removal of small ovarian cysts may be contraindicated. The repeat percentage in extrauterine pregnancies is approximately 10%, but normal pregnancy follows in 55 - 70% of the cases. The results are worse when 1 of the fallopian tubes is damaged by infection. Early diagnosis is of utmost importance, and immediate surgery minimizes tissue damage. Upon examination, the abdominal area is tender and full, and the Douglas cavity is swollen and bluish. Extrauterine pregnancy can be determined by a human chorionic gonadotropin of the placenta, and ultrasound can aid in the diagnosis. Other signs are blood pooling in the Douglas cavity, hematoma at the side of the uterus, and an empty uterus. Prolonged bleeding can cause infection and complicate diagnosis.