Hüseyin CENGİZ, Cihan KAYA, Hakan GÜRASLAN, SEMA KARAKAŞ DİKİLİTAŞ, LEVENT YAŞAR, Murat EKİN

Ektopik gebelik yönetimi: Fertilite sonuçları üzerine etkisi

Amaç: Ektopik gebelik vakalarına uygulanan cerrahi ve konservatif tedavi yaklaşımlarının operasyon sonrası fertilite sonuçlarına etkisinin değerlendirilmesi. Materyal ve Metot: Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Klini-ğinde Ocak 2007-Şubat 2011 tarihleri arasında ektopik gebelik tanısı alan ve tedavi edilen toplam 273 olgu geriye dönük olarak incelendi. Tüm hastalara telefonla ulaşıldı ve fertilite durumları sorgulandı. Bekle-gör ve metotreksat tedavisi konservatif tedavi grubunu oluştu-rurken, laparoskopi ve laparotomi uygulanan olgular cerrahi tedavi grubuna dahil edildi. Bulgular: 273 ektopik gebelik olgusunun yaş ortalaması 31,47±6,06 (17-46), gravida ve parite ortalamaları ise sırası ile 2,07±1,55 ve 1,61±1,18 olarak bulunmuştur. Olguların 48’ine (%17,6) bekle-gör, 31’ine (%11,3) metotreksat tedavisi uygulanarak konservatif tedavi grubu oluşturuldu. 125 (%45,7) olgu laparotomi, 69 (%25,3) olgu ise laparoskopi yöntemiyle tedavi edilmiş olup, bu grup cerrahi tedavi grubunu oluşturdu. Sonuç: Çalışmamızda konservatif yaklaşım ile cerrahi tedavi arasında fertilite prognozu açısından fark olmadığı görülmüştür. Ektopik gebelik tedavisi hastanın başvuru anındaki klinik durumuna ve fertilite arzusuna göre bireyselleştirilmelidir.

Anahtar Kelimeler:

Geriyedönük çalışma, Methotreksat, Gebelik, ektopik, Laparoskopi, Doğum oranı

Management of ectopic pregnancy: Effects on the fertility outcome

Objective: Evaluation of fertility outcomes of the patients who had been managed for ectopic pregnancy by conservative or surgical approach. Material and Method: 273 patients who had been diagnosed and treated for ectopic pregnancy were analyzed retrospectively during the time period between January 2007-February 2011 in Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Department of Gynecology and Obstetrics. All cases were called by phone and fertility results were questioned. The patients who had been treated by expectant management and methotrexate treatment were called as the conservative group and the second who had been treated by laparoscopy or laparotomy were called as the surgery group. Results: 273 cases with ectopic pregnacy were evaluated. The mean age was 31.47±6.06 (17-46), gravidity and parity were 2.07±1.55 and 1.61±1.18, respectively. The conservative group included 48 (17.6%) of the patients who had been treated by expectant management and 31 (11.3%) of the patients who had been treated by methotrexate. The surgery group included 125 (45.7%) of the patients who had been treated by laparotomy and 69 (25.3%) of the patients who had been treated by laparoscopy. Conclusion: In our study there was no difference on fertility outcome between the conservative or surgical management groups. Treatment of ectopic pregnancy has to be individualized according to patient’s clinical state and fertility desire at admission.

Keywords:

Retrospective Studies, Methotrexate, Pregnancy, Ectopic, Laparoscopy, Birth Rate,

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