Clinical study of unusual ectopic pregnancies

Park, Sang Hae; Lee, Seung Soo; Choi, Hyung Min

Abstract

OBJECTIVE
The purpose of this study was to evaluate the clinical characteristics and the management of the unusual ectopic pregnancies.
METHODS
Sixty one patients who were diagnosed as unusual ectopic pregnancies in the Department of Obstetrics and Gynecology, Inje University Ilsan Paik Hospital from December 1999 to June 2006, were retrospectively analyzed. The chief complaints, past histories, time of diagnosis, serum beta-hCG concentrations and method of the management were reviewed.
RESULTS
During the designated study period, the incidence rate of the ectopic pregnancy was 9.5% of the all deliveries and that of the unusual ectopic pregnancy was 18.8% of the total ectopic pregnancies. In twenty two cases, implantation sites were not found out exactly by sonography at initial diagnosis. Theses ectopic pregnancies were cornual pregnancy (3 cases), ovarian pregnancy (6 cases), abdominal pregnancy (3 cases), and unclassified unusual ectopic pregnancy (10 cases). Unusual ectopic pregnancies which were diagnosed before six weeks of gestation were eleven cases. These unusual ectopic pregnancies were 6 cases in cervical pregnancy, 1 case in abdominal pregnancy, and 4 cases in unclassified unusual ectopic pregnancy. Initial mean serum beta-hCG concentration was the highest in cornual pregnancies and the lowest in abdominal pregnancies. MTX (methotrexate) was administered in seven cases, operation was done in forty six cases, and expectant management was done in nine cases. All initial treatment was successful except one case with cornual pregnancy, which was MTX administered with alternative regimen.
CONCLUSIONS
In our study the diagnostic accuracy of the unusual ectopic pregnancy was 63.9% and the successful treatment was done in 98.3% of them. There were significant statistical differences between the serum beta-hCG concentrations and the kinds of unusual ectopic pregnancies (p<0.001).