Kliniğimizde ektopik gebelik nedeniyle tedavi edilen 64 olgunun retrospektif analizi

Ünal Turkay; Hasan Terzi; Arzu Yavuz; Ahmet Kale

EN TR

Kliniğimizde ektopik gebelik nedeniyle tedavi edilen 64 olgunun retrospektif analizi

Abstract

Aim. The aim of this study was to analyze retrospectively diagnosting modalities and treatment options of ectopic pregnancies in our clinic. Method. Sixty-four cases who were treated ectopic pregnancy in our clinic between January 2007-December 2012 have been evaluated retrospectively for demographic features, diagnosting modalities and treatment approaches. Results. The avarage age of the patients were 31.3 years. The risk factors in the order of frequencies were previous abdominopelvic surgery (17%), the use of intrauterine device (6.2%), previous ectopic pregnancies (6.2%) and previous pelvic inflammatory disease (2%). The most common complaint on admission were pelvic pain and amenorea (54.6%) and following that in the order of frequencies were vaginal bleeding with pain (40.6%) and only vaginal bleeding (4.6%). The serum mean βHCG level of the patients on admission to our clinic was 3496mLU/mL.Transvaginal ultrasonographic findings of ectopic pregnancy were seen 96.8% of cases. All of the patients were surgically 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 pregnancies are important health problems since they may interfere with fertility capability of the patient in her future life and may even cause maternal mortality. History, serum β-HCG level and TVUSG are important diagnosting tools. Surgery especially salpingectomy is still the most frequently performed treatment option in cases with tubal damage and hemodinamically instable patients.

Keywords

Ectopic pregnancy, risk factors, diagnosis, treatment

Kliniğimizde ektopik gebelik nedeniyle tedavi edilen 64 olgunun retrospektif analizi

Öz

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

Anahtar Kelimeler

Ektopik gebelik, risk faktörleri, teşhis, tedavi

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

-

Bölüm

-

Yazarlar

Ünal Turkay

Hasan Terzi

Arzu Yavuz

Ahmet Kale

Yayımlanma Tarihi

7 Mayıs 2013

Gönderilme Tarihi

7 Mayıs 2013

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2013 Cilt: 35 Sayı: 4

IZ

https://izlik.org/JA88GS82FA

Kaynak Göster

RIS / Bibtex

AMA

1.Turkay Ü, Terzi H, Yavuz A, Kale A. Kliniğimizde ektopik gebelik nedeniyle tedavi edilen 64 olgunun retrospektif analizi. CMJ. 2013;35(4):548-554. https://izlik.org/JA88GS82FA