You are here

Home » Content

Ektopik gebeliklerin laparoskopik yaklaşımla tedavilerinin retrospektif incelenmesi

Retrospective evaluation of the laparoscopic treatment of ectopic pregnancies

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2011

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
The aim of this study was to evaluate the ectopic pregnancies treated by laparoscopy in our clinic. Demographic characteristics, risk factors, clinical findings and therapeutic approaches of 182 patients treated with the diagnosis of ectopic pregnancy by laparoscopic surgery between June 2003 and September 2010 were retrospectively evaluated. The mean age of the patients was 29.3±3.05 years, the mean number of gravidity and parity was 2.3±1.0 and 1.1±0.9, respectively, and the mean gestational age was 6.2±0.8 weeks. The mean β-HCG levels of the patients on admission was 3880±2510 IU/ml. The most common risk factor was the presence of a previous abdominopelvic surgery (14%), the most frequent admission reason was vaginal bleeding with pelvic pain (40%) and the most frequent preoperative ultrasonographic finding was the presence of an adnexial mass (60%). The most frequent locus of ectopic implants was tubal ampulla (83%), and the most commonly performed treatment modality was laparoscopic salpingectomy (56%). In the treatment of ectopic pregnancies surgical approach was rather preferred than medical therapy in our series, and laparoscopic salpingectomy was the most frequently preferred procedure in cases with tubal damage as also recommended in the current literature.
Bookmark/Search this post with
Abstract (Original Language): 
Bu çalışmanın amacı kiniğimizde laparoskopik cerrahi ile tedavi edilen ektopik gebelik olgularının değerlendirilmesidir. Haziran 2003 ile Eylül 2010 tarihleri arasında ektopik gebelik nedeniyle laparoskopik cerrahi ile tedavi edilmiş olan 182 olgunun demografik özellikleri, risk faktörleri, klinik bulguları ve tedavi yaklaşımları retrospektif olarak incelenmiştir. Hastalarımızın yaş ortalaması 29.3±3.05 yıl olup, gravida ve parite ortalamaları sırasıyla 2.3±1.0 ve 1.1±0.9, ortalama gebelik haftaları ise 6.2±0.8’dir. Hastaların kliniğimize başvuruları sırasındaki ortalama serum β-HCG düzeyleri 3880±2510 IU/ml’dir. En sık saptanan risk faktörü %14 abdominopelvik cerrahi öykü, en sık kliniğe başvuru şikayeti %40 pelvik ağrı ile birlikte gö- rülen vajinal kanama ve en sık preoperatif ultrasonografi bulgusu %60 adneksiyal kitle varlığıdır. Ektopik gebeliklerin en sık yerleşim yeri tubal ampulla (%75) olarak kaydedilmiş ve en sık uygulanan cerrahi tedavi yaklaşımı ise laparoskopik salpenjektomi (%56) olmuştur. Ektopik gebeliklerin tedavisinde cerrahi yaklaşım medikal tedaviye göre daha öncelikli tercihimiz olup, özellikle tubal hasar gelişmiş olgularda önerilen cerrahi girişim olan laparoskopik salpenjektomi en sık uyguladığımız prosedür olmuştur
FULL TEXT (PDF): 
PDF icon arastirmax-ektopik-gebeliklerin-laparoskopik-yaklasimla-tedavilerinin-retrospektif-incelenmesi.pdf
  • 2
99-103
  • Turkish

REFERENCES

References: 

1. Atasü T, Sahmay S. Jinekoloji. 2nci baskı. İstanbul:
Nobel Yayınevi, 2001: 547-557.
2. Duran B, Çetin M, Timuroğlu Y, Demirköprülü N,
Timuroğlu T. Ektopik gebelik olgularının β-hCG
düzeylerinin ve mevsimlere göre dağılımının
değerlendirilmesi. C. Ü. Tıp Fakültesi Dergisi 2003; 25:
193-196.
3. Cagnacci A, Landi S, Volpe A. Rhythmic variation in
the rate of ectopic pregnancy throughout the year. Am
J Obstet Gynecol 1999; 180: 1067-1071.
4. Kirk E, Condous G, Bourne T. Ectopic pregnancy deaths:
what should we be doing? Hosp Med 2004; 65: 657-660.
5. Stovall TG, Ling FW. Single dose methotrexate: an
expanded clinical trial. Am J Obstet Gynecol 1993; 168:
1759-1765.
6. Kirk E, Condous G, Bourne T. The nonsurgical
management of ectopic pregnancy. Ultrasound Obstet
Gynecol 2006; 27: 91-100.
7. Musa J, Daru PH, Mutihir JT, Ujah IA. Ectopic pregnancy
in Jos Northern Nigeria: prevalence and impact on
subsequent fertility. Niger J Med 2009; 18: 35-38.
8. Storeide O, Veholmen M, Eide M, Bergsjø P, Sandvei
R. The incidence of ectopic pregnancy in Hordaland
County, Norway 1976-1993. Acta Obstet Gynecol
Scand 1997; 76: 345-349.Cilt 53 • Sayı 2 Ektopik gebeliklerde laparoskopi • 103
9. Bouyer J, Coste J, Shojaei T, et al. 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.
10. Alsuleiman SA, Grimes EM. Ectopic pregnancy: a review
of 147 cases. J Reprod Med 1982; 27: 101-106.
11. Turhan NÖ, İnegöl İ, Seçkin NC. A three-year audit
of the management of ectopic pregnancy. J Turkish
German Gynecol Assoc 2004; 5: 310-313.
12. Şahin HG, Zeteroğlu Ş. Sürücü R, Sucaklı MH,
Kamacı M. Ektopik gebeliklerde risk faktörleri ve tanı
yöntemlerinin değerlendirilmesi. Medical Network
Klinik Bilimler ve Doktor 2004; 10: 696-700.
13. Tancer ML, Delke I, Veridiano NP. A fifteen year
experience with ectopic pregnancy. Surg Gynecol
Obstet 1981; 152: 179-182.
14. Job-Spira N, Coste J, Aublet-Cuvelier B, et al. Incidence
of extra-uterine pregnancy and characteristics of treated
patients. First results of the auvergne registry. Presse
Med 1995; 24: 351-355.
15. Randic L, Haller H. Ectopic pregnancy among past IUD
users. Int J Gynaecol Obstet 1992; 38: 299-304.
16. Doyle MB, DeCherney AH, Diamond MP. Epidemiology
and etiology of ectopic pregnancy. Obstet Gynecol Clin
North Am 1991; 18: 1-17.
17. Pradhan P, Thapamagar SB, Maskey S. A profile of
ectopic pregnancy at Nepal medical college teaching
hospital. Nepal Med Coll J 2006; 8: 238-242.
18. Coste J, Job-Spira N, Fernandez H, Papiernik E, Spira A.
Risk factors for ectopic pregnancy: A case-control study
in France, with special focus on infectious factors. Am J
Epidemiol 1991; 133: 839-849.
19. Tharaux-Deneux C, Bouyer J, Job-Spira N, Coste J, Spira
A. Risk of ectopic pregnancy and previous induced
abortion. Am J Public Health 1998; 88: 401-405.
20. Ankum WM, Mol BW, Van der Veen F, Bossuyt PM.
Risk factors for ectopic pregnancy: A meta-analysis.
Fertil Steril 1996; 65: 1093-1099.
21. Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N.
Sites of ectopic pregnancy: a 10 year population-based
study of 1800 cases. Hum Reprod 2002; 17: 3224-3230.
22. Yao M, Tulandi T. Current status of surgical and nonsurgical treatment of ectopic pregnancy. Fertil Steril
1997; 67: 421-433.
23. Dubuisson JB, Morice P, Chapron C, et al. Salpingectomy
- the laparoscopic surgical choice for ectopic pregnancy.
Hum Reprod 1996; 11: 1199-1203.
24. Hajenius PJ, Engelsbel S, Mol BWJ, et al. Randomised
trial of systemic methotrexate versus laparoscopic
salpingostomy in tubal pregnancy. Lancet 1997; 350:
774-779.
25. Sowter MC, Farquhar CM, Petrie KJ, Gudex G. A
randomized trial comparing single dose systemic
methotrexate and laparoscopic surgery for the
treatment of unruptured tubal pregnancy. Br J Obstet
Gynecol 2000; 108: 192-203.

Thank you for copying data from http://www.arastirmax.com