From the Department of Obstetrics and Gynecology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
From the Department of Obstetrics and Gynecology, Acibadem Hospitals Group, Istanbul, Turkey.
Ann Saudi Med. 2024 May-Jun;44(3):141-145. doi: 10.5144/0256-4947.2024.141. Epub 2024 Jun 6.
Medical treatment, expectant approaches, and surgical treatment options are available in the treatment of ectopic pregnancy. Regardless of the treatment, in addition to its effectiveness, the main concern is to limit the risk of relapse and preserve fertility.
Determine the impact of medical or surgical treatment for ectopic pregnancy on future fertility.
Retrospective.
Department of obstrtrics and gynecolgy at Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.
Patients who were treated for ectopic pregnancy between June 2016 and November 2019 were allocated into two groups. Expectant approach or medical treatment by methotrexate constituted the conservative treatment group while salpingectomy by laparoscopy indicated the surgical treatment group.
Fertility rates within two years following treatment were evaluated according to treatment options.
202 patients.
Of the 202 patients, 128 had medical treatment and 74 patients had surgical treatment for ectopic pregnancy. Of 272 diagnosed with ectopic pregnancy, 70 were excluded for various reasons. Parity and unemployment rate was significantly higher in the surgical treatment (=.006 and =.12, respectively). Moreover, ectopic mass size and serum β-hCG levels were significantly higher in the surgical treatment group (<.001 and <.001, respectively). There were no significant differences between the conservative and surgical treatment groups in time to pregnancy (17.0 months vs 19.0 months, =.255). Similarly, there was no significant difference between the conservative and surgical treatment groups with respect to history of infertility (=.12). There were no significant differences between the conservative and surgical treatment groups in terms of live birth (51.6% vs 44.6%) and ectopic pregnancy (2.3% vs 1.4%) (=.72 for both). There was no significant difference between the conservative and surgical treatment groups with respect to infertility rate (35.9% vs 41.9%, =.72) and admittance to the IVF program (3.9% vs 6.8%, =.39) following ectopic pregnancy treatment.
Reproductive outcomes did not differ significantly in women undergoing expectant management, medical treatment, and surgery for ectopic pregnancy. This finding suggests that clinicians should not hesitate to act in favor of surgical treatment for ectopic pregnancy even if there were concerns for future fertility.
Retrospective study.
异位妊娠的治疗方法包括医疗、期待疗法和手术治疗。无论选择哪种治疗方法，除了有效性外，主要关注点还在于限制复发风险并保留生育能力。
确定异位妊娠的医疗或手术治疗对未来生育能力的影响。
回顾性研究。
土耳其安卡拉 Etlik Zübeyde Hanım 妇女健康培训和研究医院妇产科。
将 2016 年 6 月至 2019 年 11 月期间因异位妊娠接受治疗的患者分为两组。期待疗法或甲氨蝶呤的保守治疗为一组，而腹腔镜下输卵管切除术的手术治疗为另一组。
根据治疗方法评估治疗后两年内的生育能力。
202 例患者。
202 例患者中，128 例接受了药物治疗，74 例接受了手术治疗。在 272 例诊断为异位妊娠的患者中，有 70 例因各种原因被排除在外。手术治疗组的生育次数和失业率显著较高（分别为 P =.006 和 P =.12）。此外，手术治疗组的异位肿块大小和血清β-hCG 水平显著较高（均 P<.001）。保守治疗组和手术治疗组的妊娠时间（17.0 个月 vs 19.0 个月，P =.255）无显著差异。同样，保守治疗组和手术治疗组的不孕史也无显著差异（P =.12）。保守治疗组和手术治疗组的活产率（51.6% vs 44.6%）和异位妊娠率（2.3% vs 1.4%）（均 P =.72）也无显著差异。异位妊娠治疗后，保守治疗组和手术治疗组的不孕率（35.9% vs 41.9%，P =.72）和进入 IVF 计划的比例（3.9% vs 6.8%，P =.39）也无显著差异。
对于异位妊娠患者，期待治疗、药物治疗和手术治疗后的生殖结局无显著差异。这一发现表明，即使对未来生育能力存在担忧，临床医生也不应犹豫选择手术治疗异位妊娠。
回顾性研究。
