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A Retrospective Analysis of Ectopic Pregnancy Treatments
Author: JiaoZuoJie
Tutor: WangHuiLan
School: Hebei Medical University
Course: Obstetrics and Gynaecology
Keywords: ectopic pregnancy clinical score surgery conservati-ve surgery methotrexate mifepristone
CLC: R714.22
Type: Master's thesis
Year: 2011
Downloads: 49
Quote: 0
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Abstract
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Objective: A retrospective analysis of Methods and their effects of ectopic pregnancy in our hospital, To provide clinicians with a more comprehensive assessment of patient’s condition based on evidence-based medicine, then find the minimum side effects for the selection of the beststandard treatment.Methods: Collect 163 cases of ectopic pregnancy From February 2010 to February 2011 , according to the different treatment methods weredivided into 5 groups,groupⅠipsilateral tubal surgery (including laparos-copy and laparotomy); groupⅡconservative surgery (including Incisione-mbryo surgery and Embryos out of the umbrella-side surgery); groupⅢmifepristone oral plus methotrexate deep intramuscular ; groupⅣdeep intramuscular methotrexate ; GroupⅤwas simply anti-inflammatory and s-topping bleeding therapy. To admission, gestational age, serumβ-HCG (IU/L), Transvaginal ultrasound (TVS) of ectopic pregnancy mass maxi-mum diameter(mm) and endometrial thickness (mm) as a variable rate set ectopic pregnancy cases of each group graded. Cases at all levels of eachgrou-p were analyzed.Results:1 The clinical score of 4 to 5 , there is no significantdifference in efficac- y in groupⅢ,Ⅳ,Ⅴ(p>0.05); 6 to 7 , a considerable effect in each group(p>0.05); clinical score 8 to 9 , groupⅠ,Ⅱ,Ⅲhave the same success rate(p>0.05), but higher thanⅣ,Ⅴgroups(p<0.05); when score > 9, groupⅤwas significantly lower than the rest(p<0.05).2 Mifepristone, methotrexate combination group does not have more than 9 score case and the other levels in this group was no significant difference on the effects(p>0.05); the effect of methotrexate alone group in 8 to 9 points is lower than 6 to 7 score(p<0.05), but compare with points > 9, no significant difference between groups;in anti-inflammatory and stoppi- ng bleeding group when the score > 9 the success rate is 0%.Conclusion:1 The hospital surgery for tubal pregnancy is reliable, but when the clin- ical score≤7 there was no significant difference on efficacy to the drug conservative treatment, therefore, when a clinical score≤7 does not recomm- end surgery, but conservative treatment with medication is a better choice.2 Compare with the singl efficacy of methotrexate, methotrexate andmifepristone combined group promote better, but when the clinical score≤7 advantage is not obvious, and when 8 to 9 the combined options has le-ss side effects and better effective than the selection of operative method and methotrexate alone.3 Deep intramuscular methotrexate in clinical score≤7 reliable effe-ct for the optimal choice, but the success rate of≥8 being significantlydecreased is not recommended.4 Alone anti-inflammatory treatment of tubal pregnancy bleeding can still be subject to further Strict selection criteria and closely observe the p-atient’s condition changes.
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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Pathological pregnancy ( abnormal pregnancy ) > Ectopic pregnancy ( ectopic pregnancy )
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