Türkiye’de bulunan tersiyer bir merkezdeki non-tubal ektopik gebeliklerin retrospektif değerlendirilmesi

Yıl 2019, Cilt: 1 Sayı: 1, 1 - 6, 30.12.2019

Ömer Lütfi Tapısız , Sabri Cavkaytar , Hakan Aytan , Görkem Tuncay , Turgut Var , Hüseyin Yeşilyurt

Öz

Amaç: Non-tubal ektopik gebelikler tüm ektopik gebeliklerin %5 veya daha azını oluştursa da ektopik gebeliğe bağlı ölümlerin yaklaşık %20’sinden sorumludurlar. Non-tubal ektopik gebeliklerin klinik olarak tanı ve tedavisi zordur ve tedavi seçenekleri geleneksel olarak gelecekteki fertiliteyi etkileyecek temel cerrahi prosedürleri içermektedir. Bu çalışmanın amacı, Türkiye’de bulunan üçüncü basamak bir merkezdeki non-tubal ektopik gebeliklerin insidansını tespit etmek ve bu hastaları tubal ektopik gebeliklerden ayırt edebilmemizi sağlayacak olası farklılıkları ortaya koymaktır. 

Gereç ve Yöntem: Bu çalışmada olgular retrospektif olarak taranarak tubal ve non-tubal ektopik gebeliklerdeki hasta özellikleri ve özel incelemeleri kıyaslanmıştır. Histolojik olarak doğrulanmış 197 ektopik gebelik, iki servikal ve bir term abdominal gebelik olgusunun kayıtları analiz edilmiştir. 

Bulgular: İkiyüz ektopik gebelik olgusunun 11’i (%5.5) non-tubal, 189’u tubal ektopik gebelik şeklinde tespit edilmiştir. Non-tubal ve tubal ektopik gebelikler arasında vajinal kanama ve rektal ağrı semptomları dışında anlamlı bir fark bulunmamıştır. Vajinal kanama ve rektal ağrı non-tubal grubunda anlamlı şekilde fazla görülmüştür (sırasıyla, p=0.004 ve p=0.016).

Sonuç: Ektopik gebelik şüphesi olan bir hastada özellikle vajinal kanama ve rektal ağrı mevcutsa non-tubal lokalizasyonun olabileceği akılda tutulmalıdır.

Anahtar Kelimeler

Non tubal, ektopik gebelik, vajinal kanama, rektal ağrı

Destekleyen Kurum

Çalışmamızı destekleyen bir kurum yoktur

A retrospective review of non-tubal ectopic pregnancies in a tertiary unit in Turkey

Öz

Objective: Although non-tubal ectopic pregnancies represent 5% or less of all ectopic pregnancies, they account for approximately 20% of the mortalities attributed to ectopic gestations. Diagnosis and management of non-tubal ectopic pregnancies are clinically challenging and the treatment alternatives have traditionally included major surgical procedures, which affect future fertility. The aim of this study was to establish the incidence of non-tubal ectopic pregnancies in a tertiary unit in Turkey and to elucidate any differences that may discriminate patients from those with tubal ectopic pregnancy. 

Material and Method: This was a retrospective review of cases; comparing patient features and special investigation in patients with tubal and non-tubal ectopic pregnancy. The records of the 197 histologically confirmed ectopic pregnancies and two cervical and one term abdominal gestations were analyzed. 

Results: Eleven of 200 (5.5%) ectopic pregnancies were found to be non-tubal and the remaining 189 were tubal pregnancies. There was no significant difference between non-tubal and tubal ectopic pregnancies except for vaginal bleeding and rectal pain symptoms. Vaginal bleeding and rectal pain were observed significantly more frequent in the non-tubal group (p=0.004 and 0.016, respectively). 

Conclusion: Non-tubal location may be considered in patients with the suspicion of ectopic pregnancy especially if there are vaginal bleeding and rectal pain.

Anahtar Kelimeler

Non-tubal, ectopic pregnancy, vaginal bleeding, rectal pain

Kaynakça

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