Randriambololona D M A, Anjaharisoaniaina N T, Rekoronirina E B, Harioly M O J, Randriambelomanana J A, Andrianampanalinarivo R H
Hôpital universitaire de gynécologie et obstétrique de Befelatanana, Antananarivo, Madagascar.
Med Sante Trop. 2012 Oct-Dec;22(4):394-7. doi: 10.1684/mst.2012.0108.
Ectopic pregnancy is a serious gynecological disease requiring early diagnosis and treatment. The aim of this study is to analyze the epidemiologic, diagnostic and therapeutic aspects of this disease in a reference hospital in Madagascar.
This prospective and descriptive study included all women diagnosed with and treated for ectopic pregnancy at the University Hospital of Gynecology and Obstetrics of Befelatanana during the 6-month period from January 1 to June 30, 2011.
We recorded 107 cases of ectopic pregnancy, accounting for 2.48% of all deliveries and 5.71% of surgical procedures. The age group most often concerned was that aged 31 to 35 years (28.97%). The main risk factors were a history of miscarriages (36.45%), spontaneous abortions (29.90%), sexually transmitted infections (21.50%), and smoking (16.82%). Amenorrhea was followed by pelvic pain and then bleeding in 78.50% of patients. Tubal rupture occurred in 71% of the cases. Ultrasonography contributed to the diagnosis in 93.5% of patients and a pregnancy test in 91.6% of cases. All cases were treated and resolved by surgery, with salpingectomy in 90.7%. Anemia was the main complication and blood transfusions were required for 27.1% of the women.
The prevention of risk factors, the education of the population to consult early, and the use of laparoscopic surgery are useful for improving the treatment and prognosis of ectopic pregnancy.
异位妊娠是一种严重的妇科疾病，需要早期诊断和治疗。本研究的目的是分析马达加斯加一家参考医院中该疾病的流行病学、诊断和治疗方面。
这项前瞻性描述性研究纳入了2011年1月1日至6月30日这6个月期间在贝费拉塔纳纳妇产大学医院被诊断并接受治疗的所有异位妊娠女性。
我们记录了107例异位妊娠病例，占所有分娩的2.48%，占外科手术的5.71%。最常涉及的年龄组是31至35岁（28.97%）。主要危险因素是流产史（36.45%）、自然流产（29.90%）、性传播感染（21.50%）和吸烟（16.82%）。78.50%的患者出现闭经后伴有盆腔疼痛，然后出血。71%的病例发生输卵管破裂。超声检查对93.5%的患者诊断有帮助，妊娠试验对91.6%的病例有帮助。所有病例均通过手术治疗并治愈，90.7%进行了输卵管切除术。贫血是主要并发症，27.1%的女性需要输血。
预防危险因素、对人群进行早期咨询教育以及使用腹腔镜手术有助于改善异位妊娠的治疗和预后。
