Treatment Options And Success Rates in Ectopic Pregnancy Cases

Yıl 2014, Cilt: 11 Sayı: 1, 17 - 20, 01.01.2014

Özlem Seçilmiş Kerimoğlu , Ayşe Gül Kebapçılar Aybike Pekin Setenay Arzu Yılmaz Fatma Beyhekim Çetin Çelik

Öz

Aim: The aim of this study is to determine treatment approaches and success rates of ectopic pregnancy which had been diagnosed in our department during the last three years.Materials and methods: A total of 77 ectopic pregnancy cases were retrospectively analyzed between 2010 and 2013.Results: Age range of the patients was 20-44 years with a mean of 29.27 ± 4.99. Site of the ectopic pregnancy cases had been identified as 74 97% tubal, one 1% cervical, 1 1% overial and 1 1% in the cesarean section scarline. The rate of response was 68.5% with methotrexate. No maternal death was observed. Conclusion: Ectopic pregnancy is an important issue because of affecting fertility and high rates of mortality and morbidity.

Anahtar Kelimeler

Ectopic, pregnancy, treatment, methotrexate

Ektopik Gebelik Olgularında Tedavi Seçenekleri ve Başarı Oranlarımız

Öz

Giriş: Bu çalışmanın amacı kliniğimizde son üç yılda ektopik gebelik tanısı ile tedavi edilen hastaların tanı ve tedavi yaklaşımlarının irdelenerek tedavi başarı oranlarımızın belirlenmesidir.Gereç ve yöntem: 2010 ve 2013 tarihleri arasinda ektopik gebelik tanısı alan ve tedavi edilen toplam 77 olgu retrospektif olarak incelendi.Bulgular: Vakalarımızın yaş aralığı 20-44 yaş olup, ortalaması 29.27 ± 4.99 olarak saptandı. Olgularımızın ektopik gebelik yerleşim yeri 74 % 97 tubal, 1 % 1 servikal, 1 % 1 ovaryal ve 1 % 1 ise sezeryan skar hattı idi. Metotreksat tedavisine yanıt % 68.5 olarak hesaplandı. Maternal mortalite görülmedi.Sonuç: Ektopik gebelik fertiliteyi etkilemesi, mortalite ve morbiditesinin yüksek olması bakımından günümüzde hala önemini koruyan bir hastalıktır.

Anahtar Kelimeler

Ektopik, gebelik, tedavi, metotreksat

Kaynakça

• 1. Cunningham FG, Leveno KJ, Bloom SL et al (eds). Ectopic pregnancy. In Williams Obstetrics; 22. edition, 2005, New-York, The Mc Graw Hill Company: 253-273.
• 2. Farquhar CM. Ectopic pregnancy. Lancet 2005; 366:583-591.
• 3. Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ 2005; 173:905-12.
• 4. Kamwendo F, Forslin L, Bodin L, Danielsson D. Epidemiology of ectopic pregnancy during a 28 year period and the role of pelvic inflammatory disease. Sex Transm Infect 2000; 76:28-32.
• 5. Ectopic pregnancy-United States, 1990–1992. MMWR Morb Mortal Wkly Rep 1995; 44:46-48.
• 6. Van Den Eeden SK, Shan J, Bruce C, Glasser M. Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol 2005; 105:1052-1057.
• 7. Savaris RF, Cavazzola LT. Ectopic pregnancy: laparoendoscopic single-site surgery--laparoscopic surgery through a single cutaneous incision. Fertil Steril 2009; 92:1170.e5-7.
• 8. Fujishita A, Masuzaki H, Khan KN, et al. Laparoscopic salpingotomy for tubal pregnancy: comparison of linear salpingotomy with and without suturing. Hum Reprod 2004; 19:1195-1200.
• 9. Bangsgaard N, Lund CO, Ottesen B, Nilas L. Improved fertility following conservative surgical treatment of ectopic pregnancy. BJOG 2003; 110:765-770.
• 10. ACOG Practice Bulletin No. 94: Medical Management of Ectopic Pregnancy. 2008; 111: 1479-1485.
• 11. Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, Job-Spira N. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population based study in France. Am J Epidemiol 2003; 157: 185-194.
• 12. Seeber BE, Barnhart KT. Suspected ectopic pregnancy. Obstet Gynecol 2006; 107:399-413.
• 13. Zane SB, Kieke BA Jr, Kendrick JS, Bruce C. Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. Matern Child Health J 2002; 6:227- 236.
• 14. Downey LV, Zun LS. Indicators of potential for rupture for ectopics seen in the emergency department. J Emerj Trauma Shock 2011; 4: 374-377.
• 15. Moawad NS, Mahajan ST, Moniz MH, et al. Current diagnosis and treatment of interstitial pregnancy. Am J Obstet Gynecol 2010; 202:15-29.
• 16. Lipscomb GH. Medical therapy for ectopic pregnancy. Semin Reprod Med 2007; 25:93.
• 17. Kirk E, Condous G, Bourne T. The non-surgical management of ectopic pregnancy. Ultrasound Obstet Gynecol 2006; 27:91–100.
• 18. Gamzu R, Almog B, Levin Y, Avni A, Jaffa A, Lessing JB, et al. Efficacy of methotrexate treatment in extrauterine pregnancies defined by increasing human chorionic gonadotropin concentrations. Fertil Steril 2002; 77: 761-765.
• 19. Hajenius PJ, Mol F, Mol BW, et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev 2007; :CD000324.
• 20. Tozer AJ, Shaxted E. A review of the use of minimally invasive surgery in the management of ectopic pregnancy in a district general hospital. Gynaecological Endoscopy. 1996;5: 21–24.