Özet:

INTRODUCTION: Ectopic pregnancy is mostly settles in a fallopian tube (97 %). The most common cause of ectopic pregnancy is the pelvic inflammatory disease, while tubal surgery is the most important risk factor for ectopic pregnancy. In this study we analyzed medical and surgical results of ectopic pregnancies in our clinic. METHODS: We retrospectively analyzed 73 cases of ectopic pregnancy hospitalized in the out-patient clinics of Obstetrics and Gynecology Bağcılar Training and Research Hospital between 1 January - 31 December 2011. Previous pelvic inflammatory disease, ectopic pregnancy, IUD, tubal surgery were investigated. Single dose methotrexate (50 mg/m2 IM) was injected to hemodynamically stable cases, and cases with β-hücreG values below 500=IU. Surgical treatment (laparotomy, laparoscopy) was planned for cases with fetal cardiac activity and/or those with higher β-hCG levels (>5000). Patients were followed after the treatment until β-hCG levels dropped below 5 IU. RESULTS: In 70 cases (95.8 %) ectopic pregnancy was located in tubes and in 3 cases (4.2 %) in the cornual area. The most common presenting complaint was groin pain (82.1 %). Previous abdominopelvic surgery (10.9 %), ectopic pregnancy (9.5 %), IUD (9.5 %), and pelvic infections (6.8 %) was learnt from their anamneses. Thirty-nine cases underwent surgical interventions (24 laparotomies, and 15 laparoscopies). Cases with a history of surgery was treated with salpingectomy, while for cases with cornual pregnancies salpingectomy was combined with cornual resection. Single dose methotrexate was injected into 34 cases but in 6 of them whose hemodynamic status deteriorated, needed surgery afterwards. Single dose methotrexate was succesful in 82.3 % of the patients and none of them needed repetitive doses of methotrexate. DISCUSSION AND CONCLUSION: Effective treatment is achieved by surgery in all patients. The success rate was high in the medical treatment too. In cases with ectopic pregnancy, provided that early diagnosis is made, medical treatment seems to be a good option in women who desire to have a child.

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