Laparoscopic Management of Ectopic Pregnancy: Study of 128 Cases Collected from 2013 to 2023 at the Biasa Clinic, Togo

Objective: To describe the diagnostic, therapeutic, and prognostic aspects of the laparoscopic management of ectopic pregnancy (EP) at the BIASA clinic. Methodology: Descriptive retrospective study on the coelioscopic management of ectopic pregnancy carried out from January 1, 2013, to December 31, 2023, at the BIASA Clinic, a period of 11 years. Result: Over a period of 11 years, 4015 pregnancies were recorded, and 130 cases of EP were treated, among which 128 were treated by laparoscopy, i.e., 98.5% of EPs. The incidence of EP was 3.24% of pregnancies and 3.2% for those treated by laparoscopy. The average age of the patients was 31 years. The most common risk factors were a history of abdominopelvic surgery (31.3%), a history of recurrent upper genital infection (28.2%), contraception with IUD TCu380A (16.4%), and a history of EP (14.1%). Clinically, pelvic pain (67.2%), metrorrhagia (82.8%), and the clinical triad (45.3%) were the main signs of EP. There was a correlation between the site of the ectopic pregnancy and the procedure (p = 0.000), the site of the ectopic pregnancy and the duration of the procedure (p = 0.005), and the duration of hospitalization and the site of the ectopic pregnancy (p = 0.000). Ultrasound was performed in all patients. Salpingectomy was the most commonly used procedure (78.9%), followed by salpingotomy (19.5%). Maternal morbidity was not negligible, with 40% of patients receiving a transfusion. Conclusion: The study identified key risk factors, including prior abdominopelvic surgery, STIs, use of intrauterine devices, and prior ectopic pregnancy. Salpingectomy was the preferred treatment option. The study provides sufficient evidence that laparoscopy can mitigate maternal complications and reduce mortality rates.