Skjeldestad F E, Kendrick J S, Atrash H K, Daltveit A K
Department of Gynecology and Obstetrics, Norwegian University of Science and Technology, Trondheim.
Acta Obstet Gynecol Scand. 1997 Feb;76(2):159-65. doi: 10.3109/00016349709050073.
To estimate time trends related to ectopic pregnancy while considering the contribution of repeat ectopic pregnancy and changing treatment for infertile couples over the past 24 years.
Population based incidence data on ectopic pregnancy were collected from the only two hospitals in one Norwegian county from 1970 through 1993. Cases were identified through hospital discharge registries and all medical records were reviewed. Only females, aged 15-44 years, living permanently in the county and having a histologically verified ectopic pregnancy were eligible for the study. Data were analyzed in 5-year periods and 5-year age-groups.
The incidence of ectopic pregnancy (per 1,000 woman-years) increased fourfold from the first to the last period. When we restricted the analyses to women with no previous ectopic pregnancy and no previous infertility surgery or treatment, we observed a linear threefold increase in the number of ectopic pregnancies.
Repeat ectopic pregnancy and increased infertility treatment in the late 1970s and early 1980s might explain at most 25% of the increase in the incidence of ectopic pregnancy. After 1985, assisted reproduction might contribute to 4-5% of ectopic pregnancies diagnosed. The introduction of laparoscopy might explain some of this increase in the 1970s; however, we doubt that the introduction of more sensitive pregnancy tests or vaginal ultrasound in the 1980s contributed to the observed increase in ectopic pregnancy.
在考虑重复异位妊娠的影响以及过去24年中不孕夫妇治疗方法变化的情况下，评估与异位妊娠相关的时间趋势。
收集了挪威一个县仅有的两家医院1970年至1993年基于人群的异位妊娠发病率数据。通过医院出院登记册识别病例，并对所有医疗记录进行审查。只有年龄在15 - 44岁、永久居住在该县且经组织学证实为异位妊娠的女性才符合研究条件。数据按5年时间段和5岁年龄组进行分析。
从第一个时间段到最后一个时间段，异位妊娠的发病率（每1000妇女年）增加了四倍。当我们将分析限制在既往没有异位妊娠且没有接受过不孕手术或治疗的女性时，我们观察到异位妊娠数量呈线性增加了三倍。
20世纪70年代末和80年代初重复异位妊娠的增加以及不孕治疗的增多，最多可能解释异位妊娠发病率增加的25%。1985年以后，辅助生殖可能导致4% - 5%的异位妊娠被诊断出来。腹腔镜检查的引入可能解释了20世纪70年代异位妊娠增加的部分原因；然而，我们怀疑20世纪80年代引入更敏感的妊娠试验或阴道超声是否导致了观察到的异位妊娠增加。
