Abstract        Aim: To compare the efficiency of laparoscopic treatment versus conventional abdominal surgery in the treatment of ectopic pregnancy (EP) Objective: 1) To study the clinical profile of patients with ectopic pregnancy 2) To evaluate the methods of diagnosis in the above patients, 3)To identify the risk factors in these patients, 4) To study the treatment modalities in these patients, 5) To compare the outcome of all the surgically managed cases (either by laparotomy or laparoscopy). Methodology :This observational study was conducted over five years, retrospectively from 1st July 2009 to 31st December 2012 (Group A) and prospectively from 1^st Jan 2013 to 30^th June 2014 (Group B) at Gandhi Medical College, a tertiary care hospital located at Secunderabad, Telangana State which caters to both rural and urban population. Risk factors leading to ectopic pregnancy, the clinical presentations, the status at admission, the methods of diagnosis, the treatment modalities(laparoscopy and laparotomy), and the outcome of all the surgically managed cases was studied. A total of 202casesof ectopic pregnancies were diagnosed and treated during this period, of which 140 were in group A and 62 in group B.66 cases were managed laparoscopically and the other 136 had conventional abdominal surgery (laparotomy). Results: Laparoscopic surgery gives an overall success rate of 98.9% 1)Linear salpingostomy was the main procedure performed in unruptured ectopic (9.3% in Group A and 10.63%in group B) whereas salpingectomy was the procedure for ruptured ectopic in both groups (81.25%in Group A and 68.08 %in Group B). Milking of the tubes was done in 3.13% and 8.51% women in Group A and Group B respectively 2) Estimated blood loss was significantly lower in the laparoscopy group(P<0.0001) 3)The duration of hospitalization was significantly shorter in the laparoscopy group(p<0.0001) 4)Only 8% of the patients in laparoscopy group required blood transfusion whereas 31% of patients in laparotomy group needed blood transfusion. 5) There were no intraoperative complications in either group. 6) Thirty two (32) (48.4%)patients in the laparoscopy group did not need analgesia as compared to the laparotomy group where all patients needed analgesia after surgery. 7)There was no maternal mortality in both groups. Conclusion: With high index of suspicion, aggressive and timely management, maternal mortality and morbidity in ectopic pregnancy can be lowered. Moreover the trend in management of ectopic pregnancy is changing from laparotomy to laparoscopy. Laparoscopic treatment (salpingostomy or salpingectomy) of EP’s offers major benefits superior to laparotomy in terms of less blood loss, less need for blood transfusion, less need for post operative analgesia and a shorter duration of hospital stay.

Keywords: Ectopic pregnancy (EP), Laparoscopy, Laparotomy, Salpingectomy.