ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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ORİJİNAL ARAŞTIRMALAR

Tubal Ektopik Gebelik Tedavisinde Farklı Tedavi Yöntemlerinin Sonraki Üreme Sonuçları Üzerine Etkisinin Karşılaştırılması
Comparison of the Effects of Different Treatment Methods on Subsequent Reproductive Results in Tubal Ectopic Pregnancy Treatment
Received Date : 14 Aug 2023
Accepted Date : 17 Aug 2023
Available Online : 31 Aug 2023
Doi: 10.24074/tjrms.2023-99057 - Makale Dili: EN
TJRMS. 2023;7(3):101-6
ÖZET
Amaç: Ektopik gebeliğin ideal yönetimi hala tartışılmaktadır ve ilk tedavilerin gelecekteki üreme sonuçları üzerindeki etkisi, üreme endokrinolojisi ile ilgilenen klinisyenler için önemli bir endişe kaynağıdır. Bu çalışmada, tubal ektopik gebelik nedeniyle medikal veya cerrahi olarak tedavi edilen hastaların sonraki fertilite sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: Ocak 2014 ve Aralık 2016 tarihleri arasında üçüncü basamak bir merkezde tedavi edilen 287 ektopik gebelik hastasının kayıtları retrospektif olarak incelendi. Hastaların sonraki reprodüktif sonuçları telefon görüşmesi ile öğrenildi 153 hasta takip protokolünü tam olarak takip etti ve telefon görüşmesinde çalışma için onay verdi. Bulgular: Hastaların yaş ortalaması 31.98 idi. Radikal cerrahi (salpinjektomi) 75 (%45) kadına, konservatif cerrahi (salpingostomi) 24 (%15) kadına uygulandı ve 54 (%35,2) kadın için medikal tedavi seçildi. Dokuz hasta medikal tedavideki başarısızlık nedeniyle ameliyat edildi. EP tedavisi gören 153 kadından 79'u (%52) gebe kalmayı denedi. Gebe kalmayı deneyen 79 kadından 40'ı (%51) kendiliğinden, 19'u (%24) ise yardımcı üreme teknolojisi ile gebe kalmıştır. Tedavi modaliteleri gebe kalabilen ve kalamayan hastalar arasında farklılık göstermemiştir. Sonuç: Çalışmamızın sonuçları, mümkün olduğunda, nüks riskini artırmadan sonraki fertilite sonuçlarını güçlendirmek için konservatif bir tedavi yöntemi seçmenin tercih edilebilir olduğunu göstermektedir.
ABSTRACT
Objective: Ideal management of ectopic pregnancy is still debated and effect of initial treatments on future reproductive outcome is a major concern for clinicians’ dealing with reproductive endocrinology. In this study, we aimed to compare the subsequent fertility outcome of patients who were treated for tubal ectopic pregnancy either medically or surgically. Material and Methods: We retrospectively reviewed records of 287 ectopic pregnancy patients who were treated in a tertiary care centre between January 2014 and December 2016. Subsequent reproductive outcomes of patients learned by phone interview. 153 patients accompanied follow-up protocol fully, and gave consent for study in phone interview. Results: Mean age of patients was 31.98. Radical surgery (salpingectomy) was performed in 75 (45%) women, conservative surgery (salpingostomy) was performed in 24 (15%) women, and medical therapy was chosen for 54 (35.2%) women. Nine patients were operated due to failure in medical therapy. Among 153 women who treated for EP, 79 (52%) of them try to conceive. Among the 79 women who attempted to conceive, 40 (51%) became pregnant spontaneously and 19 (24%) got pregnant with assisted reproductive technology Treatment modalities did not differ between patients who could achieve pregnant and who could not. Conclusion: Results of our study show that; it seems preferable, whenever it is possible, choosing a conservative treatment method to potentiate subsequent fertility outcome while not increasing the risk of recurrence.
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