Tubal ectopic pregnancy

Abstract

The records of 417 tubal pregnancies which occurred in 396 patients over a period of eight years at University College Hospital, Jamaica, are reviewed. The incidence was one ectopic pregnancy to 28 live births. Although the data do not throw much light on the problems of aetiology, they indicate that certain symptoms hitherto considered to be typical, such as amenorrhoea shoulder-tip pain, and “prune-juice” bleeding, may be quite uncommon. Other features, such as abdominal rebound tenderness and severe pain on movement of the cervix, are very useful in diagnosis. The problems of diagnosis are considered in the. light of errors made during the years reported in this series. In treatment, a policy of immediate operation, supplemented by transfusion of blood, either from a donor or by autotransfusion from blood in the abdominal cavity, is justified, we believe, by the low mortality rate of 1.2%. The incidence of a second or third ectopic pregnancy in these patients is of the order of 10%. © 1963, British Medical Journal Publishing Group. All rights reserved.