[Chronic salpingitis and extra-uterine pregnancy. Results of the histologic study of 215 tubal pregnancies]

215 women who had tubal pregnancy were treated by total salpingectomy at the University Hospital Port-Royal between the 1st January 1977 and the 30th January 1986. All of these had histological examination of the tube in which the pregnancy occurred. Our series of histological examinations confirms that tubal pregnancy occurs in the great majority of cases in a tube that is already pathological. The responsibility for tubal abnormalities in the occurrence of tubal pregnancy has been suggested by a comparative study of a control series where chronic lesions of the tube were statistically far less frequent (p less than 0.001). Ampullary pregnancy, of which there were 200 cases, was associated in 89.5% of the cases with a pathological condition of the ampulla. Isthmic pregnancy, of which there were 15 cases, would seem to be secondary to a pathology in the isthmus in all cases except one, and is nearly always associated with lesions in the ampulla. Chronic salpingitis was the main histological lesion that was observed. It represented 95.5% of the abnormalities of the ampulla in ampullary pregnancies. In isthmic pregnancies it was found in two-thirds of cases attacking the isthmus, the ampulla or the whole tube. Isthmic salpingitis nodosa was the second lesion that was observed in 40% of isthmic pregnancies. As far as endometriosis is concerned, it is very rare and occurred in only one case. Prevention of tubal pregnancy, therefore, necessarily must lie in preventing tubal infections and sexually transmitted diseases.(ABSTRACT TRUNCATED AT 250 WORDS)