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
Bulut VARLIa, Kaan BAYDEMİRb, Çağatayhan ÖZTÜRKa, Meltem SÖNMEZERc, Göksel KANMAZd
aDepartment of Obstetrics and Gynecology, Ankara University, Faculty of Medicine, Ankara, Türkiye
bClinic of Obstetrics and Gynecology, Private Losante Hospital, Ankara, Türkiye
cPrivate Physician, Ankara, Türkiye
dClinic of Obstetrics and Gynecology, Health Sciences University, Izmir Tepecik Education and Research Hospital, İzmir, Türkiye
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.
Anahtar Kelimeler: Ektopik gebelik; metotreksat; salpinjektomi; salpingostomi
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.
Keywords: Ectopic pregnancy; methotrexate; salpingectomy, salpingostomy
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