采用手术、甲氨蝶呤或期待疗法治疗输卵管异位妊娠的 2 年生殖效果比较。

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-09-27 DOI:10.1007/s00404-024-07747-0
Fahri Burçin Fıratlıgil, Sadun Sucu, Serap Topkara Sucu, Merve Ayas Ozkan, Yildiz Akdas Reis, Murat Levent Dereli, Sadullah Ozkan, Yaprak Engin-Ustun
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摘要

简介:目的:比较采用手术、甲氨蝶呤(MTX)或期待疗法治疗输卵管异位妊娠(EP)的 2 年生殖结局:目的:比较采用手术、甲氨蝶呤(MTX)或期待疗法治疗输卵管异位妊娠(EP)的两年生育结果:这项病例对照研究在 Etlik Zubeyde Hanim 妇女健康教育和培训医院的妇产科和围产期诊所进行。在2015年1月至2019年12月期间接受输卵管EP治疗的1156名患者中,有985人在治疗后2年内尝试怀孕:366名患者接受了手术治疗;549名患者接受了MTX治疗,70名患者接受了期待治疗。临床数据和生育结果均来自医疗和住院记录。我们根据输卵管EP三种治疗方式的2年生育结果对三组患者进行了比较:结果:与接受期待疗法和MTX治疗的患者相比,接受手术治疗的患者未孕频率有明显差异(P 结论:接受手术治疗的患者未来可能会怀孕,而接受期待疗法和MTX治疗的患者未来可能不会怀孕:输卵管伞端造口术患者通常都有生育的愿望,因此治疗方案也很重要。诊断越早,越有可能考虑期待疗法或 MTX 治疗。采用这两种治疗方法,未来生育的可能性要高于手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Comparison of 2-year reproductive outcomes of tubal ectopic pregnancies treated with surgery, methotrexate or expectant management

Introduction

To compare the 2-year reproductive outcomes of tubal ectopic pregnancies (EP) treated with surgery, methotrexate (MTX) or expectant management.

Materials and methods

This case–control study was conducted retrospectively at the Obstetrics-Gynecology and Perinatology Clinics of Etlik Zubeyde Hanim Women’s Health Education and Training Hospital. 985 of 1156 patients, who were managed between January 2015 and December 2019 for a tubal EP, tried to conceive in 2 years after treatment: 366 patients underwent surgical treatment; 549 patients were treated with MTX, and 70 patients had expectant management. Clinical data and fertility outcomes were retrieved by medical and hospital records. We compared the three groups based on the 2-year reproductive outcomes of three treatment modalities of tubal EP.

Results

There was a significant difference in the frequency of no pregnancy in patients who underwent surgery compared to patients who received expectant management and MTX therapy (p < 0.001). The frequency of no pregnancy was higher in patients who underwent surgery. There was no significant difference between expectant management and MTX therapy (p = 0.411). In the reproductive outcomes of patients who underwent surgery, the incidence of viable pregnancies was statistically lower than in the group treated with expectant management and MTX therapy (p = 0.003).

Conclusions

Patients with an EP often have a future desire to have children, the treatment options are also important. The earlier the diagnosis is made, the more likely it is that expectant management or MTX treatment will be considered. With these two treatment methods, the likelihood of having a child in the future is higher than with surgical treatment.

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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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