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KMID : 0654219920010000283
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Journal of Asan Welfare Foundation Haesung General Hospital
1992 Volume.1 No. 0 p.283 ~ p.291
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A Clinical Study on the Ectopic Pregnancy Following Laparoscopic Tubal Sterilization
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김상경/Kim, S.K.
이광열/탁영오/이기학/권기상/Lee, K.Y./Tark, Y.O./Lee, K.H./Kwon, G.S.
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Abstract
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This report is a review of the 57 cases of ectopic pregnancy after laparoscopic tubal sterilization from January 1,1988 to Jun 30, 1990 at the Department of Obstetrics & Gynecology, Hae Sung General Hospital. A retrospective clinical study was undertaken the relation between ectopic pregnancy and laparoscopic tubal sterilization with a review of world I terature.
The results were as follows:
1. The incidence of ectopic pregnancy with laparoscopic tubal sterilization history was 35.6%.
2. Average age was 32.4 years and the most prevalent age group was 30 34 years (47.4%).
3. In 42 cases (73.3 %), gravidity range was between 3 to 6 and the highest incidence was noted in party 3 4 (51.0 %).
4. Majority of patient (93.0 %) have 2 to 3 children and average number of child was 2.6.
5. The method of sterilization; electrocauterization was 56 cases (98.2 %) and Falope ring was 1 case (1.8 %).
6. The most prevalent interval between last menstrual period and diagnosis of ectopic pregnancy was 5 ^-´6 weeks (35.1 %) and average interval was 6.3 weeks.
7. Ectopic pregnancy after laparoscopic tubal sterilization occured in 56.1 % within 4 years, with the shortest interval being 5 month and the longest 10 years.
8. Lower abdominal pain was the single most common presenting symptom (55 cases 96.4 %), with abnormal uterine bleeding occuring in 21 cases (36.4 %). Urine hCG test was positive in 48 cases (84.2 %). Culdocentesis was performed in 57 cases and was positive foi a free fluid of blood in 46 cases (80.7 %). The initial average hemoglobin level was 10.7 gm/dl with the lowest level being 6.7 mg/dl and highest 13.6 gm/dl.
9. The location of ectopic pregnancy were in order of pregnancy 27 patients in the ampullar, 15 patients in the isthmic, 13 patients interstitial and 2 patients in the fimbrial portion. The fate of ectopic pregnancy; abortive type was 26 cases (45.6 %) and ruptured type was 31 cases (54.4 %).
10. In 28 cases (49.1 %), amount of intraperitoneal blood was ranging from 500 cc to 1,500 cc.
11. An average 3.1 pints of whole blood was transfused with highest 6 pints and none of transfusion was 21 cases (36.8 %).
12. 63.2 % of total cases were treated by salpingo-oophorectomy, 29.8 % by salpingectomy, 3.5 % by total hysterectomy and 3.5 % by cornual resection.
It is concluded that the laparoscopic tubal sterilization is a certain causative factor in ectopic pregnancy.
It is suggested that the propriety of laparoscopic tubal cauterization as a laparoscopic sterilization and the development of new tubal sterilization method should be reconsidered.
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