Demirdag E, Guler I, Abay S, Oguz Y, Erdem M, Erdem A
Department of Obstetrics and Gynecology, Gazi University School of Medicine, 06500, Besevler-Ankara, Turkey.
Ir J Med Sci. 2017 May;186(2):387-392. doi: 10.1007/s11845-016-1419-5. Epub 2016 Feb 19.
The most common treatment modalities of ectopic pregnancy may influence long-term subsequent fertility outcomes in women who previously treated for ectopic pregnancy.
Our objective was to compare long-term subsequent fertility outcomes after treatment with expectant management, systemic methotrexate (MTX) and surgery in tubal ectopic pregnancy.
We searched our database for all women diagnosed with tubal ectopic pregnancy between January 2007 and January 2011 who were managed expectantly, with systemic MTX and with surgery. Treatment success and spontaneous pregnancy rates were compared in patients who desire to conceive following a tubal pregnancy.
One hundred twelve of 151 women desired to conceive following tubal ectopic pregnancy. Twenty-seven of 112 (24.1 %) patients were managed expectantly. Fifty-three (47.3 %) and 32 (28.5 %) patients were managed with systemic MTX or surgery, respectively. All patients in expectant and surgery groups were managed successfully. Two (3.7 %) patients had surgery after failed treatment with systemic MTX. Spontaneous intrauterine pregnancy rates were 62.9 % in expectantly managed women, 58.4 % in women with systemic MTX and 68.7 % in women with surgery (p > 0.05).
Treatment of ectopic pregnancy with either expectant management or systemic MTX is equally effective as compared to surgery. Spontaneous intrauterine pregnancy rates were comparable in expectant management, systemic methotrexate and surgery.
异位妊娠最常见的治疗方式可能会影响既往接受过异位妊娠治疗的女性的长期后续生育结局。
我们的目标是比较输卵管异位妊娠采用期待治疗、全身应用甲氨蝶呤（MTX）和手术治疗后的长期后续生育结局。
我们在数据库中搜索了2007年1月至2011年1月期间所有诊断为输卵管异位妊娠且分别接受期待治疗、全身应用MTX和手术治疗的女性。比较了输卵管妊娠后希望怀孕的患者的治疗成功率和自然妊娠率。
151名女性中有112名希望在输卵管异位妊娠后怀孕。112名患者中有27名（24.1%）接受期待治疗。分别有53名（47.3%）和32名（28.5%）患者接受全身MTX或手术治疗。期待治疗组和手术组的所有患者治疗均成功。2名（3.7%）患者在全身MTX治疗失败后接受了手术。期待治疗组女性的自然宫内妊娠率为62.9%，全身应用MTX组为58.4%，手术组为68.7%（p>0.05）。
与手术相比，期待治疗或全身应用MTX治疗异位妊娠同样有效。期待治疗、全身应用甲氨蝶呤和手术的自然宫内妊娠率相当。
