Ektopik Gebelik Olgularında Tedavi Yaklaşımları

Year 2007, Volume: 24 Issue: 2, 37 - 42, 29.12.2009

M. Tosun A. Kaya A. Kökçü E. Malatyalıoğlu M.B. Çetinkaya T. Alper

Abstract

Treatment Management in Ectopic Pregnancy

The incidence of ectopic pregnancy has increased in the recent years and it has been the most important cause of maternal mortality and morbidity in the first trimester. The management of ectopic pregnancy changes regarding the factors such as, the hemodynamic stability of the patient at the initial diagnosis, desire to maintain fertility and the degree of the tubal injury.
In our study, 68 patients diagnosed with ectopic pregnancy in the last five years in Gynecology and Obstetrics Department of Ondokuz Mayis University, Faculty of Medicine were retrospectively examined. The ratios of operative as well as nonoperative methods applied to the patients, the success rates and the factors affecting the achievement were evaluated. A total of 57 patients were operated and 11 patients had non operative treatment. It was concluded that ectopic pregnancy should be frequently considered in the early and differential diagnosis to decrease the morbidity and cost rates as well as to increase the perce ntage of nonoperative management.


Ektopik gebelik, görülme sıklığı son yıllarda artmakta olup, maternal mortalite ve morbidi-tenin ilk trimesterde en önemli nedeni olmaya devam etmektedir. Ektopik gebelik olguların-daki tedavi yaklaşımı, tanı anındaki hastanın hemodinamik stabilitesi, fertilite arzusu, tubal hasar düzeyi gibi faktörlere bağlı olarak değişiklik göstermektedir.
Çalışmamızda, son beş yılda Ondokuz Mayıs Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği'nde ektopik gebelik tanısı konulan 68 hasta retrospektif olarak incelendi. Hastalara uygulanan operatif ve nonoperatif tedavi yöntemlerinin oranları, başarı yüzdeleri ve başarıyı etkileyen faktörler değerlendirildi. Toplam 57 hastada cerrahi yaklaşım, 11 hastada ise nonoperatif tedavi uygulandı.
Maliyet ve morbidite oranlarının azaltılması, nonoperatif tedavi yüzdelerinin arttırılması için erken tanı ve ön tanılar arasında ektopik gebeliğin daha sık düşünülmesi gerektiği sonucuna varıldı.

Keywords

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