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KMID : 0616619970030030191
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Journal of Soonchunhyang Medical College
1997 Volume.3 No. 3 p.191 ~ p.203
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A Clinico-Statistical Analysis and Survey of Ectopic Pregnancy
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金義弘/Kim E.H.
金泳/韓康鶴/徐炳和/Kim M.D./HanK.H./Suh B.H.
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Abstract
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This study is a clinico-statistical analysis and survey of 260 cases who were admitted and treated for ectopie pregnancy at Soon chun Hyang hospital from June 1, 1974 to May 31, 1980.
The results of this study were as follows:
1. The incidence (f ectopic pregnancy was 1 : 34 or 3.0% of deliveries and tends to increase the cases every year.
2. The most frequent age group was in 25~39 years of age (81.5%) and the mean age was 31.5 years.
3. Nulligravida was 13.8%, nullipara 29.2% and multipara 70.8% and the cases who have experienced artificial abortion over one time was 65.4% and the last pregnacy ended in normal delivery in 21.2% and artificial abortion in 48.8% of total.
4. The mean duration of sterility was 3 years and 4 months and 7.3% was 9 years or more of sterility.
5. A history of previous artificial abortion was 65.4% and previous laparotomy 19.2% among them, repeat ectopic pregnancy was 8. 1% and appendectomy in 5.4% and laparcscopic sterilization was 3.8%. 4.6% was pelvic inflammatory disease, vaginitis in 3.5% co, pelvic tuberculosis in 1.5%, IUD in 1. 5% and cervicitis in 1. 2%. The duration between the first and second ectopic pregnancies was distributed in 3 months to 12years and its mean was 4years and 6months. Particullary there was one case of third ectopic pregnancy on same side (left).
6. Symptoms were lower abdominal pain in 93. 1%, vaginal spotting or bleeding in 66. 9%, nausea and vomiting in 16.2%, dizziness or fainting in 13.8%, bearing down ser_sation in 11.2% and shoulder pain in 1.9%. On pelvic examination, lower abdominal tenderness was noted in 83. 1%, adnexal mass in 45.4%, pain on motion of the cervix in 56. 5% abdominal distention in 24. 2%, abdominal rigidity in 16. 2% and shock in 11. 2%. Vaginal bleeding combined lower abdominal pain was present in 58. 1% of total cases, vaginal bleeding preceeded pain in 24. 6%, the reverse being 8. 8% and simultaneous cases in 24.6%.
7. The mean interval between L.N.M.P and onset of symptoms was 6.2 weeks.
8. The mean hemoglobin level was 10.6mg% and the mean hematocrit was 32.8 % . Hemoglobin, level less than 10mg% was found in 30.8% and the amount of free peritoneal blood over 1, 000ml in 31.5%. The mean amount of transfusion was 3 pints in transfused cases.
9. The W.B.C count over 10,000/㎣ was 33.5 % and considerably increased in ruptured cases.
10. Culdocentesis was performed in 81.5% (212 cases) and the accuracy of culdocentesis. was 95.2%. The Gravindex test was positive in 48.1%. The total diagnostic accuracy was 92. 2% and diagnostic error in 7.1 %.
11. Ectopic pregnancy was implanted on tube in 90%, ovary in 1.5%, cornus in 7.7% and cervix in 0.4%. Of tubal pregnancies, ampullar portion was involved in 60.4%, isthmic portion in 17.3%, fimbrial portion in 9.6% and interstitial portion in 2.7%. Particullary there were one case of combined pregnancy (coexisting right cornual pregnancy and intrauterine pregnancy) and one case of simultaneous pergnancy in both uterine cornuses.
12. In terminations of tubal pregnancy, tubal rupture was found in 59%, tubal abortion in 31. 6% and intact or unruptured type in 9.4%.
13. 71.5% of total cases were treated by salpingectomy, 14%, by salpingo-oophorectomy and cornual resection in 5%. The incidental procedures were opposite tubal ligation in 20.8%, appendectomy in 36.5%, hysterectomy in 5.4% and tuboplasty in 1.5%.
14. Concpmittent diseases of ectopic pregnancies were pelvic inflammatory disease in 8.5%, ovarian cyst in 5%, hydro3alpinx in 3.8%, uterine myoma in 1.90, appendicitis in 1.5%, squamous cell carcinoma. of cervix in 0.5% and plevic tuberculosis in 0.5%.
15. The mean duration of admission was 7.4 days and there was no specific postoperative complications of total cases.
16. Of 260 total cases, there was no death.
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