|
The study is a clinico-statistical analysis of 223 cases who were admitted and treated at Presbyterian Medical Center from Jan. 1, 1973 to Dec. 31, 1977. The results were as follows; 1) The incidence of ectopic pregnancy was 1 in 21 deliveries. There has been no significant increase or decrease in the incidence of ectopic pregnancy. 2) The most frequent age group was in 25-39 years of age, comprising of 64.1%. 3) Nulligravida was 5.3%, nullipara 22.4% and the cases who have experienced artificial abortion over one time was 45.3%. 4) The mean duration of sterility was 3 years 8 months and 11.2% was 9 years or more of sterility. 5) A history of previous curettage was 45.3% and previous laparotomy 16.5%. Of previous laparotomy, repeat ectopic pregnancy was found in 8.5%. 2.7% was pelvic inflammatory disease and IUD in 2.2%. 6) Symtoms were lower abdominal pain in 89.6%, vaginal spotting in 67.2%, nausea and vomiting in 22.4%, dizziness in 26.8%, bearing down sensation in 8.1%, urgency and frequency in 2.7% and shoulder pain in 2.1%. On pelvic examination, abdominal tenderness was noted in 78.5%, adnexal mass in 36.3%, pain on the motion of cervix in 55.6%, abdominal distention in 28.2%, enlarged uterus in 15.6% and shock in 21.5%. 7) Culdocentesis was positive in 95.4% and Gravindex test was positive in 45.1%. 8) On implantation site, tubal pregnancy was detected in 92.0%, ovary in 1.3%, cornus in 4.9%, cervix in 1.3% and peritoneum in 0.5%. Of tubal pregnancies, fimbrial extremity was noted in 11.7%, ampullar portion in 66.8% isthmic portion in 18.6% and interstitial portion in 2.9% respectively. 9) Hemoglobin level less than 10mg% was found in 69.1% and the amount of free peritoneal blood over 1000cc in 72.2%. 10) Tubal pregnancy were terminated by rupture in 67.3%, by abortion in 31.4% and unruptured in 1.3%. 11) 90.5% of total cases was treated by salpingectomy and 35.8%, by salpingoophorectomy. The incidental procedures were tubal ligation in 15.6%, appendectomy in 14.8%, total abdominal hyste
|