Uprety D, Banerjee B
Department of Obstetrics & Gynaecology, BP Koirala Institute of Health Sciences, Dharan, Nepal.
Kathmandu Univ Med J (KUMJ). 2005 Oct-Dec;3(4):365-9.
Ectopic pregnancy remains an important cause of morbidity and mortality in early pregnancy. The incidence has increased worldwide with an increase in pelvic infections and improvements in the diagnostic techniques. The objective of this study was to analyse the various aspects of ectopic pregnancy with a view to suggest interventions which would decrease the incidence.
The study was carried out in the department of Obstetrics and Gynaecology, B.P Koirala Institute of Health Sciences, Dharan (Nepal). Data were analysed retrospectively using the case sheets and operative notes from the past two years (April 02-April 04). The gynaecological admissions and records of the total births within the period of study were also used in the analysis.
The incidence of ectopic pregnancy during this study period was 0.93 of total births and 2.92% of the total gynaecological admissions. The peak age of incidence was in the range of 26-30 years. Majority of patients were in the lower socioeconomic group. Pelvic inflammatory disease and induced abortions were the major risk factors. Their contribution was 61.3% and 38.6% respectively. 70.6% of patients did not use any contraception. 16% used depo provera. Abdominal pain (69.3%), vaginal bleeding (45.3%) and syncopal attacks (21.3%) were the most frequent presenting complaints. 58.6% had amenorrhea of 6-10 weeks. Only 1.3% presented with amenorrhea of greater than 10 weeks. Ampulla (62.6%) followed by isthmus (21.3) were the commonest sites of ectopic implantation. Ovarian and abdominal pregnancies contributed to only 1.3% each. There was no significant difference between the side of the tube involved.82.6% had come with ruptured ectopic but only 12% were in shock. Majority of patients underwent salpingectomy (69.3%) followed by salpingo-oophorectomy (17.3%). Only 2.6% received methotrexate. 70.6% required blood transfusion.
Majority of patients attending BPKIHS for ectopic pregnancy were between 26-30 years and had history of PID & induced abortions. Surgery (salpingectomy/salpingo-oophorectomy) was the main stay of treatment.
异位妊娠仍然是早期妊娠发病和死亡的重要原因。随着盆腔感染的增加和诊断技术的改进，其发病率在全球范围内有所上升。本研究的目的是分析异位妊娠的各个方面，以期提出能够降低发病率的干预措施。
本研究在尼泊尔达兰的BP柯伊拉腊健康科学研究所妇产科进行。使用过去两年（2002年4月至2004年4月）的病历表和手术记录进行回顾性数据分析。研究期间的妇科住院病例和总出生记录也用于分析。
本研究期间异位妊娠的发病率为总出生数的0.93%，占妇科住院总数的2.92%。发病的高峰年龄在26至30岁之间。大多数患者属于社会经济地位较低的群体。盆腔炎和人工流产是主要危险因素，其贡献率分别为61.3%和38.6%。70.6%的患者未采取任何避孕措施。16%使用了醋酸甲羟孕酮。腹痛（69.3%）、阴道出血（45.3%）和晕厥发作（21.3%）是最常见的就诊主诉。58.6%的患者闭经6至10周。只有1.3%的患者闭经超过10周。壶腹部（62.6%）其次是峡部（21.3%）是异位着床最常见的部位。卵巢妊娠和腹腔妊娠各占1.3%。受累输卵管的侧别之间无显著差异。82.6%的患者为破裂的异位妊娠，但只有12%的患者休克。大多数患者接受了输卵管切除术（69.3%），其次是输卵管卵巢切除术（17.3%）。只有2.6%的患者接受了甲氨蝶呤治疗。70.6%的患者需要输血。
在BP柯伊拉腊健康科学研究所就诊的异位妊娠患者大多数年龄在26至30岁之间，有盆腔炎和人工流产史。手术（输卵管切除术/输卵管卵巢切除术）是主要的治疗方法。
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