FREE USE OF LAPAROSCOPY IN THE MODERN MANAGEMENT OF ECTOPIC PREGNANCY

Regarding the false negative results of culdocentesis, it is believed that the protocol of B-hCG, sonography, D&C and free use of laparoscopy gives more reliable information to the physician than the protocol of B-hCG, sonography and culdocentesis. We used the former protocol on 50 patients suspected of having ectopic pregnancy. The most common diagnoses were EP (48%) and PID (16%), respectively. It seems, in contrary to reports from abroad, among differential diagnosis of EP, ovarian cyst is not very common in Iranian patients. One of the objectives of our protocol was to determine if the use of laparoscopy with laparotomy causes an increase in the rate of postoperative infection and elongates the stay of the patient in hospital. Thus we compared our new protocol with the old protocol (gravindex, culdocentesis, laparotomy) of management ofEPin our hospitaifrom the point of: 1- the length of stay in hospital before and after laparotomy, and 2- the rate of laparotomy infection. There was no statistical difference between the two groups. The results of this comparison proved that laparoscopy when used with laparotomy does not cause increased morbidity for the patients. The most prominent feature of our special new protocol was the free use of laparoscopy.1t is believed that the free use of laparoscopy has the following advantages: 1- Elimination of false negative results of culdocentesis and encourage the surgeon to perform essential laparotomies. 2- Identification of some cases of EP that can be managed conservatively. 3- Identification of the non-EP cases that should not be operated on.