Gynecologists are agreed as to the necessity of immediate operation in unruptured tubal pregnancy; it is in the ruptured variety that opinions differ with regard to the indication for immediate operation.
While I have always maintained that tubal pregnancy is a surgical disease, requiring surgical intervention as soon as possible, I have never insisted, and do not now, that an unruptured tubal pregnancy must be rushed to operation; on the contrary, there is no particular danger or risk to the patient if, for some good reason, the operation is postponed for a short time, provided, however, that the patient is kept under close observation and is so situated that an operation can be performed at once in the event of rupture. On the other hand, it is in ruptured tubal pregnancy, especially when it is accompanied by shock and collapse, that I advocate and urge the immediate operation.
LADINSKI LJ. TREATMENT OF TUBAL PREGNANCY: WITH SPECIAL REFERENCE TO IMMEDIATE OPERATION FOR RUPTURE, BASED ON A STUDY OF TWO HUNDRED OPERATIONS. JAMA. 1912;LIX(11):854–859. doi:10.1001/jama.1912.04270090098009
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