Prevalence and Severity of Endometriosis at Laparoscopic Treatment of Tubal Ectopic Pregnancy

BACKGROUND: Endometriosis may have a causal role in ectopic pregnancies. AIMS: To observe the prevalence and staging of endometriosis in women at the time of laparoscopic treatment of tubal ectopic pregnancy. METHODS: Prospective observational cohort study carried out in a tertiary obstetrics and gynaecology hospital. Seventy participants with ectopic pregnancy requiring laparoscopic treatment were recruited. A pre-operative questionnaire was completed by patients regarding symptoms of endometriosis and gynaecological history. A post operative questionnaire was completed by the surgical team regarding site of ectopic pregnancy, presence or absence of endometriosis and severity of endometriosis. RESULTS: After the exclusion of patients with non-tubal ectopic pregnancies, results were examined for 65 patients. Of the 65 histologically confirmed ectopic pregnancies, 36 had laparoscopically confirmed endometriosis, demonstrating a prevalence rate of 55% in our cohort. r-ARSM stage I or II (minimal or mild) disease made up 92% (33/36) of cases. There was little correlation between severity of patient symptoms and severity of endometriosis on laparoscopic evaluation. CONCLUSION: This study demonstrates endometriosis is significantly more common in women with surgically managed tubal EP compared to the general population.