Murat SÖNMEZER, Bülent BERKER, Fulya DÖKMECİ, Esra ÇETİNKAYA, Korhan KAHRAMAN, Emine SEZGİNKURT, Murat GÖZÜKÜÇÜK

Ektopik gebelik olgularında tanı kriterlerinin tedavi seçimine etkisi

Amaç: Ektopik gebelik olgularında tedavi seçiminde rol oynayan faktörleri belirlemek. Hastalar Ve Yöntem: Ankara Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı’nda Ocak 1998-Temmuz 2006 tarihleri arasında ektopik gebelik tanısı konulan ve tedavi edilen toplam 150 hastanın verileri retrospektif olarak değerlendirildi. Sonuçlar: Toplam 150 hastanın 109’una (%72,9) cerrahi uygulanırken, 23 hasta (%15,3 ) parenteral Metotreksat ile tedavi edildi. Onsekiz hasta (%11,8 ) tedavi verilmeden izlendi. Cerrahi uygulanan 109 hastanın 83’üne (%76,1) laparoskopi, 26’sına (%23,9) laparotomi uygulandı. Laparoskopi yapılan 55 hastaya (%66) salpinjektomi, 23 hastaya (%27,6) salpingostomi yapılırken, kalan 5 hastada (%6,4) fimbrial yerleşim gösteren gebelik materyali fimbrial uçtan ekstirpe edildi. Laparotomi olan bütün hastalara salpinjektomi yapıldı. Tedavi verilmeden takip edilen hastalarda bhCG düzeyleri anlamlı olarak daha düşüktü (P

The effect of the diagnostic criterias to the preferred treatment in the patients diagnosed as ectopic pregnancy

Objectiv: The aim of this study is to determine the factors affecting the treatment choice of ectopic pregnancy Patients And The Methods: The conditions that may affect the choice and the treament modalities of 150 patients diagnosed as ectopic pregnancy in Ankara University Faculty of Medicine Department of Gynecology and Obstetrics between January 1998 and July 2006 were assessed respectively. Results: A hundred and nine (72,9%) of 150 patients were treated surgically, 23 (15,3%) got medical treatment and 18 patients (11,8%) were observed without getting any treatment (%11,8). Salpingectomy at 55 (66%) patients, salpingostomy at 23 (27,6%) patients and milking at 5 (6,4%) patients were done in the group of 83 patients (55,3%) at whom laparoscopy was performed. Patients in laparatomy group were treated with salpingectomy. The expectant group’s hCG level was significantly lower than the other group’s hCG levels (P

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1) Lozeau AM, Potter B. Diagnosis and management of ectopic pregnancy. Am Fam Physician 2005;72(9):1707-1714.
2) Hajenius PJ, Mol BW, Bossuyt PM, Ankum WM, Van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev 2000;(1):CD00324.
3) Farguhar CM. Ectopic pregnancy. Lancet 2005;366:583-591.
4) Tulandi T, Saleh A. Surgical Management of Ectopic Pregnancy.Clin Obst.&Gyn. Volume 42(1), March 1999, pp 31-38.
5) Aharoni A., Guyot B. and Salat-Baroux J. Operative laparoscopy for ectopic pregnancy: how experienced should the surgeon be? Human Reproduction; 1993:8, 2227– 2230.
6) Yao M, Tulandi T. Current status of surgical and nonsurgical management of ectopic pregnancy. Fertil Steril. 1997;67:421-433.
7) Oelsner G, Goldenberg D, Admon M, et al. Salpingectomy by operative laparoscopy and subsequent reproductive performance. Human Reprod. 1994;9:83-86.
8) Royal College of Obstetricians and Gynaecologists (RCOG) (1999) Guideline no. 21 The Management of Tubal Pregnancy. London, RCOG Press.
9) Tozer AJ, Shaxted E. A review of the use of minimally invasive surgery in the management of ectopic pregnancy in a district general hospital. Gynaecological Endoscopy. 1996;5: 21–24.
10) Lundorff P, Thorburn, Lindblom B. Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial. Fertil Steril. 1992;57:998-1002.
11) Kirk E, Bourne T. The nonsurgical management of ectopic pregnancy. Current Opinion in Obstetrics and Gynecology 2006;18:587–593.
12) Shalev E, Peleg D, Tsabari A, Romano S, Bustan M. Spontaneous resolution of ectopic tubal pregnancy: natural history. Fertil Steril 1995;63:15-9.
13) Trio D, Strobelt N, Picciolo C, et al. Prognostic factors for successful expectant management of ectopic pregnancy. Fertil Steril 1995; 63:469–472.