Arzu YAVUZ, Hasan TERZİ, Ünal TURKAY, Ahmet KALE

Kliniğimizde ektopik gebelik nedeniyle tedavi edilen 64 olgunun retrospektif analizi

Amaç. Kliniğimizde ektopik gebelik tanısı alan hastaların tanı yöntemleri ve tedavi seçenekleriaçısından retrospektif analizlerini yapmak. Yöntem. Ocak 2007-Aralık 2012 tarihleri arasındakliniğimizde ektopik gebelik tanısı alan ve tedavisi yapılan 64 olgu demografik özelliklerine,tanısal yöntemlerine ve tedavi seçeneklerine göre değerlendirildi. Bulgular. Hastalarımızın yaşortalaması 31,3tür. Risk faktörleri sıklık sırasına göre abdominopelvik cerrahi öyküsü (%17),rahim içi araç (RİA) öyküsü (%6,2), geçirilmiş ektopik gebelik öyküsü (%6,2), pelvik inflamatuarhastalık öyküsü (PID) (% 2) idi. Hastaların kliniğimize en sık başvuru şikayeti pelvik ağrı veamenore (%54,6) olup bunu takiben sırası ile, vajinal kanama ile birlikte pelvik ağrı (%40.6) vesadece vajinal kanamaydı (%4,6). Başvuru esnasında olguların ortalama insan koryonikgonadotropin (β-HCG) değeri 3496mLU/mL olarak tespit edildi. Olguların %96,8ine yapılantransvajinal ultrasonda (TVUSG) ektopik gebelik bulguları mevcuttu. Bütün hastalar cerrahi olaraktedavi edildi. Operasyonların %53ü laparotomi ile, %47si laparoskopi ile yapıldı. Yapılanameliyatlar salpenjektomi (%62,5), salpingostomi (%29,7), parsiyel ooferektomi (%3,1) veooferektomi (%1,6) idi. Sonuç. Ektopik gebelikler, hastanın ilerideki hayatta fertilite yeteneğinibozması hatta maternal mortaliteye yol açabilmesi nedeniyle önemli bir sağlık sorunudur.Sunduğumuz çalışma, ektopik gebeliğin tanısında anamnez, β-HCG ve transvajinal ultrasonunönemini göstermektedir. Tedavide ise cerrahi özellikle salpenjektomi; tubal hasarlı vehemodinamik olarak instabil olgularda en sık tercih edilen yöntem olarak öne çıkmaktadır.

Retrospective analysis of 64 patients treated with ectopic pregnancy in our clinic

Aim. The aim of this study was to analyze retrospectively diagnosting modalities and treatmentoptions of ectopic pregnancies in our clinic. Method. Sixty-four cases who were treated ectopicpregnancy in our clinic between January 2007-December 2012 have been evaluated retrospectivelyfor demographic features, diagnosting modalities and treatment approaches. Results. The avarageage of the patients were 31.3 years. The risk factors in the order of frequencies were previousabdominopelvic surgery (17%), the use of intrauterine device (6.2%), previous ectopic pregnancies(6.2%) and previous pelvic inflammatory disease (2%). The most common complaint onadmission were pelvic pain and amenorea (54.6%) and following that in the order of frequencieswere vaginal bleeding with pain (40.6%) and only vaginal bleeding (4.6%). The serum mean β- HCG level of the patients on admission to our clinic was 3496mLU/mL.Transvaginalultrasonographic findings of ectopic pregnancy were seen 96.8% of cases. All of the patients weresurgically treated in our series. Fifty-three percent of patients were treated by laparotomy, 48%were treated with laparoscopy.Surgical procedures were salpingectomy (62.5%), salpingostomy(29.7%), partial oopherectomy (3.1%) and oopherectomy(1.6%). Conclusion. Ectopic pregnanciesare important health problems since they may interfere with fertility capability of the patient in herfuture life and may even cause maternal mortality. History, serum β-HCG level and TVUSG areimportant diagnosting tools. Surgery especially salpingectomy is still the most frequentlyperformed treatment option in cases with tubal damage and hemodinamically instable patients.

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