Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center

Bibliographic Details
Main Author: Karuserci,Özge Kömürcü
Publication Date: 2020
Other Authors: Sucu,Seyhun
Format: Article
Language: eng
Source: Revista brasileira de ginecologia e obstetrícia (Online)
Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001200800
Summary: Abstract Objective In recent years, there has been an increase in the incidence of ectopic pregnancies; therefore, it is important for tertiary centers to report their approaches and outcomes to expand and improve treatment modalities. The aim of the present study was to evaluate the general characteristics, treatment and outcomes of cases diagnosed with ectopic pregnancy. Methods In total, 432 patients treated for ectopic pregnancy between February 2016 and June 2019 were retrospectively evaluated. Results Overall, 370 patients had tubal pregnancy, 32 had cesarean scar pregnancy, 18 had pregnancy of unknown location, 6 had cervical pregnancy, and 6 had interstitial pregnancy. The most important risk factors were advanced age (> 35 years; prevalence: 31.2%) and smoking (prevalence: 27.1%). Thirty patients who did not have any symptoms of rupture and whose human chorionic gonadotropin (β-hCG) levels were ≤ 200 mIU/ml were followed-up with expectant management, while 316 patients whose β-hCG levels were between 1,500 mIU/ml and 5,000 mIU/ml did not have an intrauterine gestational sac on the transvaginal or abdominal ultrasound, did not demonstrate findings of rupture, and were treated with a systemic multi-dose methotrexate treatment protocol. In total, 24 patients who did not respond to the medical treatment, 20 patients whose β-hCG levels were > 5,000 mIU/ml, 16 patients who had shown symptoms of rupture at the initial presentation, and 6 patients diagnosed with interstitial pregnancy underwent surgery. Patients with cervical and scar pregnancies underwent ultrasound-guided curettage, and no additional treatment was needed. Conclusion The fertility status of the patients, the clinical and laboratory findings, and the levels of β-hCG are the factors that must be considered in planning the appropriate treatment.
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spelling Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Centerectopic pregnancytreatmentmethotrexatesurgeryexpectant managementAbstract Objective In recent years, there has been an increase in the incidence of ectopic pregnancies; therefore, it is important for tertiary centers to report their approaches and outcomes to expand and improve treatment modalities. The aim of the present study was to evaluate the general characteristics, treatment and outcomes of cases diagnosed with ectopic pregnancy. Methods In total, 432 patients treated for ectopic pregnancy between February 2016 and June 2019 were retrospectively evaluated. Results Overall, 370 patients had tubal pregnancy, 32 had cesarean scar pregnancy, 18 had pregnancy of unknown location, 6 had cervical pregnancy, and 6 had interstitial pregnancy. The most important risk factors were advanced age (> 35 years; prevalence: 31.2%) and smoking (prevalence: 27.1%). Thirty patients who did not have any symptoms of rupture and whose human chorionic gonadotropin (β-hCG) levels were ≤ 200 mIU/ml were followed-up with expectant management, while 316 patients whose β-hCG levels were between 1,500 mIU/ml and 5,000 mIU/ml did not have an intrauterine gestational sac on the transvaginal or abdominal ultrasound, did not demonstrate findings of rupture, and were treated with a systemic multi-dose methotrexate treatment protocol. In total, 24 patients who did not respond to the medical treatment, 20 patients whose β-hCG levels were > 5,000 mIU/ml, 16 patients who had shown symptoms of rupture at the initial presentation, and 6 patients diagnosed with interstitial pregnancy underwent surgery. Patients with cervical and scar pregnancies underwent ultrasound-guided curettage, and no additional treatment was needed. Conclusion The fertility status of the patients, the clinical and laboratory findings, and the levels of β-hCG are the factors that must be considered in planning the appropriate treatment.Federação Brasileira das Sociedades de Ginecologia e Obstetrícia2020-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001200800Revista Brasileira de Ginecologia e Obstetrícia v.42 n.12 2020reponame:Revista brasileira de ginecologia e obstetrícia (Online)instname:Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)instacron:FEBRASGO10.1055/s-0040-1718444info:eu-repo/semantics/openAccessKaruserci,Özge KömürcüSucu,Seyhuneng2021-01-06T00:00:00Zoai:scielo:S0100-72032020001200800Revistahttp://www.scielo.br/rbgohttps://old.scielo.br/oai/scielo-oai.phppublicações@febrasgo.org.br||rbgo@fmrp.usp.br1806-93390100-7203opendoar:2021-01-06T00:00Revista brasileira de ginecologia e obstetrícia (Online) - Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)false
dc.title.none.fl_str_mv Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
title Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
spellingShingle Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
Karuserci,Özge Kömürcü
ectopic pregnancy
treatment
methotrexate
surgery
expectant management
title_short Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
title_full Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
title_fullStr Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
title_full_unstemmed Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
title_sort Retrospective Evaluation of Patients Treated for Ectopic Pregnancy: Experience of a Tertiary Center
author Karuserci,Özge Kömürcü
author_facet Karuserci,Özge Kömürcü
Sucu,Seyhun
author_role author
author2 Sucu,Seyhun
author2_role author
dc.contributor.author.fl_str_mv Karuserci,Özge Kömürcü
Sucu,Seyhun
dc.subject.por.fl_str_mv ectopic pregnancy
treatment
methotrexate
surgery
expectant management
topic ectopic pregnancy
treatment
methotrexate
surgery
expectant management
description Abstract Objective In recent years, there has been an increase in the incidence of ectopic pregnancies; therefore, it is important for tertiary centers to report their approaches and outcomes to expand and improve treatment modalities. The aim of the present study was to evaluate the general characteristics, treatment and outcomes of cases diagnosed with ectopic pregnancy. Methods In total, 432 patients treated for ectopic pregnancy between February 2016 and June 2019 were retrospectively evaluated. Results Overall, 370 patients had tubal pregnancy, 32 had cesarean scar pregnancy, 18 had pregnancy of unknown location, 6 had cervical pregnancy, and 6 had interstitial pregnancy. The most important risk factors were advanced age (> 35 years; prevalence: 31.2%) and smoking (prevalence: 27.1%). Thirty patients who did not have any symptoms of rupture and whose human chorionic gonadotropin (β-hCG) levels were ≤ 200 mIU/ml were followed-up with expectant management, while 316 patients whose β-hCG levels were between 1,500 mIU/ml and 5,000 mIU/ml did not have an intrauterine gestational sac on the transvaginal or abdominal ultrasound, did not demonstrate findings of rupture, and were treated with a systemic multi-dose methotrexate treatment protocol. In total, 24 patients who did not respond to the medical treatment, 20 patients whose β-hCG levels were > 5,000 mIU/ml, 16 patients who had shown symptoms of rupture at the initial presentation, and 6 patients diagnosed with interstitial pregnancy underwent surgery. Patients with cervical and scar pregnancies underwent ultrasound-guided curettage, and no additional treatment was needed. Conclusion The fertility status of the patients, the clinical and laboratory findings, and the levels of β-hCG are the factors that must be considered in planning the appropriate treatment.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001200800
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1055/s-0040-1718444
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dc.publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
dc.source.none.fl_str_mv Revista Brasileira de Ginecologia e Obstetrícia v.42 n.12 2020
reponame:Revista brasileira de ginecologia e obstetrícia (Online)
instname:Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)
instacron:FEBRASGO
instname_str Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)
instacron_str FEBRASGO
institution FEBRASGO
reponame_str Revista brasileira de ginecologia e obstetrícia (Online)
collection Revista brasileira de ginecologia e obstetrícia (Online)
repository.name.fl_str_mv Revista brasileira de ginecologia e obstetrícia (Online) - Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)
repository.mail.fl_str_mv publicações@febrasgo.org.br||rbgo@fmrp.usp.br
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