[Changes in the diagnosis and therapy of extrauterine pregnancy with special emphasis on ultrasound. Study at the Gynecologic Clinic of the Düsseldorf University, 1962-1983].

The diagnosis and therapy of ectopic pregnancy underwent a change with the introduction of ultrasound and the sensitive beta-hCG test. The modified management of ectopic pregnancy at the Department of Gynaecology of the University of Düsseldorf was analysed by examining the case history of 938 patients with suspected ectopic pregnancy from 1962-1983. The diagnosis ectopic pregnancy was confirmed for 348 patients (37%), whereas it was excluded in 590 cases (63%). The Pregnosticon test and the Gonavislide test yielded positive results in only little more than half of the cases with ectopic pregnancy. The Neo-Pregnosticon test was positive for 13 out of 15 patients. There was no ectopic pregnancy with a negative beta-hCG test (n = 31). Out of 261 patients examined by ultrasound, an ectopic pregnancy was proved directly four times. Sonographic pointers to an ectopic pregnancy were found with equal frequency in patients with confirmed ectopic pregnancy and in patients with excluded ectopic pregnancy (79%). In 17% of the patients with confirmed ectopic pregnancy this could not be detected by ultrasound. Out of 92 patients who had an ultrasound examination and a beta-hCG test, an intrauterine pregnancy could be excluded in spite of a positive pregnancy test in 94% of the ectopic pregnancies (n = 31) and in 31% of the cases with excluded ectopic pregnancy (n = 61). The incidence rate of ruptured tubule pregnancy was 44% before the introduction of ultrasound in 1973; it dropped subsequently to 37%. Since the introduction of the beta-hCG test in 1981 the incidence dropped further to 21%.(ABSTRACT TRUNCATED AT 250 WORDS)