[Extrauterine pregnancy].

Abstract

The pattern of ectopic pregnancy, defined by an ectopic site of the fertilised ovum, has changed in recent years in developed countries. It is only rarely responsible for maternal death in industrialised countries though the possibility remains (1/4000). However, it plays an increasing role in the pathophysiology of female infertility. In terms of epidemiology, the increase in its rate is linked to that of salpingitis and sexually transmitted diseases, and the sequelae of tubal surgery. Regarding symptomatology and prognosis, dramatic, life-threatening forms are in clear decline, because of the possibility of the early detection of pregnancy by sensitive and rapid assay of beta sub-unit human chorionic gonadotrophin (beta-hCG) and transvaginal ultrasonography. This enables conservative management regarding the tube, but is associated with the risk of recurrence. In terms of treatment, laparoscopic surgery is gradually taking the place of laparotomy. Such laparoscopic surgery must now be considered "theoretically" to be the reference treatment. Medical treatment methods using methotrexate are currently being evaluated and it is even possible in certain cases to suggest that no treatment is required.