A Clinical Study of Ectopic Pregnancy during Recent 5 years

Cheon, Min Jung; Kwon, Yong Ill; Lew, Young Oak; Lee, Bang Hyun; Lee, Hee Joong; Kim, Chan Joo; Kwon, Dong Jin; Lee, Jin Woo; Park, Tae Chul

Abstract

OBJECTIVE
The incidence of ectopic pregnancy is increasing recently. To establish the quick and accurate diagnosis of ectopic pregnancy, we reviewed and analyzed the cases during recent 5 years.
METHODS
Study datas was acquired from the 448 cases of the ectopic pregnancies who were managed and confirmed histopathologically at the our hospital from Jan. 1 1995 to Dec. 31 1999.
RESULTS
The incidence of ectopic pregnancy was 1 in 20 deliveries. The most common age group was 26-30 years of age(34.4%). A previous history of abdominal or pelvic surgery was in 42.1% and tubal sterilization was in 14.1%, pelvic inflammatory disease was in 8.3%. Hemoglobin value over 10.0 gm/dl was in 79.2% and below 8.0 gm/dl in 4.5%. Initial systolic blood pressure risen above 100mmHg was in 79.0%. The most frequent intervals between last menstrual period and the onset of symptom was 6~8 weeks in 56.0%. The clinical manifestations were appeared in 78.8% from the last menstrual period to the next 4~8 weeks. In clinical symptoms, amenorrhea was encountered in 91.7%, lower abdominal pain in 88.3% and vaginal spotting in 47.3%. Ectopic gestation was implanted on the fallopian tube in 97.1%, the ovary in 1.1%, the cervix in 0.7%, the intraabdominal in 0.9% and 1 case was intramural pregnancy. Total amount of intraperitoneal hemorrhage between 100-999ml was in 59.5%, above 1,000ml in 37.5% and less than 100 ml in 3.0%. Of total 448 cases, laparotomy was done in 229 cases(51.0%) and pelvisopic surgery in 219 cases(49.0%). The mean hospital stay was 3.1 days in pelviscopy procedure and 5.0 days in laparotomy. The operative precedures were salpingectomy in 87.5%, salpingo-oophorectomy in 4.9%, cornual resection in 6.3%, ovarian wedge resection in 0.7%, and oophorectomy in 0.2%. There was no dead case in all ectopic pregnancy. Average admission period after laparoscopy was 3.1 day and after laparotomy was 5.0 day.
CONCLUSION
The cognizing of increasing incidence of ectopic pregnancy, early diagnosis and early treatment is presumed to decrease mortality and increase fertility. The successful treatment and decision is a challenge to the clinician who must consider the patient's needs with appropriate tactfulness.