Namık Kemal DURU, İbrahim ALANBAY, Murat MUHCU, Uğur KESKİN, Vedat ATAY

Ektopik gebelik tedavisi sonrasında (laparoskopik salpingostomi ve sistemik methotrexate) tubal patensin değerlendirilmesi

Amaç: Laparoskopik salpingostomi ve sistemik tek doz Methotrexate uygulanan hastalarda tubal tedavi sonrası tubal patensi değerlendirmektir. Gereç ve Yöntem: Bu çalışma Ocak 2005-Temmuz 2007 tarihleri arasında, Ektopik gebelik tanısı ile laparoskopik salpingostomi uygulanan 28 hasta ve 50 mg/m2 tek doz Methotrexate uygulanan 14 hasta da yapılmıştır. Hastaların tümüne 3 aylık kontrasepsiyon sonrası tubal patensinin değerlendirilmesi amacı ile histerosalpingografı planlandı. İstatistiksel analiz için, SPSS for Windows 13.0 paket programı kullanıldı. Bulgular: Laparoskopik salpingostomi uygulanan grupta ortalama yaş 30,6 (-/+ 4,5) iken, Methotrexate uygulanan grupta ise 30,07 (-/+ 3,6) idi.(p: 0,68) Hastaların gravida ve par iteler i değerlendirildiğinde sırası ile laparoskopik salpingostomi uygulanan grupta 0,92 (-/+ 1,11), 0,50 (-/+ 0,63) iken; Methotrexate uygulanan grupta ise 0,78 (-/+ 0,8), 0,5 (-/+ 0,65) idi. Laparoskopik salpingostomi uygulanan hastaların 8 inde (% 28,6) ipsilateral tubal obstrüksiyon izlenirken, tek doz 50 mg/m2 Methotrexate tedavisi uygulanan hastalardan 5 inde (% 35,7) ipsilateral obstrüksiyon izlendi. Sonuç: Elde edilen veriler ipsilateral tubal obstrüksiyon oranı ve kontralateral tubal obstrüksiyon oranı her iki grupta benzer olarak bulunmuştur. Tubal geçirgenlik üzerinde; unrüptüre ektopik gebelik olgularında uygun kriterlere göre davranıldığı zaman anlamlı fark göstermemektedir.

Anahtar Kelimeler:

Salpingostomi, Gebelik, ektopik, Methotreksat, Fallop tüpü açıklık testleri

The evaluation of the tubal patency after ectopic pregnancy treatment (laparoscopic salpingostomy and systemic methotrexate)

Aim: To evaluate tubal patency in patients with ectopic pregnancy treated by laparoscopic salpingostomy and systemic single dose methotreaxate Materials and Methods: This study was included 28 patients with ectopic pregnancy treated by laparoscopic salpingostomy and 14 patients with ectopic pregnancy treated by 50 mg/m2 single dose methotrexate, from January 2005 to July 2007. All patients were evaluated by hysterosalpingography after after three months contraception. SPSS for Windows 13.0 was used for statistical analysis. Results: The mean age was 30.6±4.5 in patients treated-by laparoscopy, whereas it was 30.07±3.6 in patients treated by methotrexate (p: 0,68). Gravidity andpartity were 0,92±l,ll and 0,50 ± 0,63 in patients treated by laparoscopy, whereas they were 0,78 ±0,8 and 0,5 ±0,65 in patients treated by methotrexate respectively. There were 8 patients (28,6 %) with ipsilateral tubal oclusion in laparoscopy group, whereas there were 5 patients (%37.5) with ipsilateral tubal oclusion in methotrexate group. Conclusion: Our results showed that the ipsilateral and contralateral tubal oclusion rate is similar in both groups. Tubal oclusion rate appears similar in patients with ectopic pregnancy treated with appropriate criteria.

Keywords:

Salpingostomy, Pregnancy, Ectopic, Methotrexate, Fallopian Tube Patency Tests,

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