ABSTRACT
OBJECTIVE: The incidence of ectopic pregnancy is increasing recently. To establish the quick and accurate diagnosis of ectopic pregnancy, we reviewed and analyzed the cases during recent 5 years. METHODS: Study datas was acquired from the 448 cases of the ectopic pregnancies who were managed and confirmed histopathologically at the our hospital from Jan. 1 1995 to Dec. 31 1999. RESULTS: The incidence of ectopic pregnancy was 1 in 20 deliveries. The most common age group was 26-30 years of age(34.4%). A previous history of abdominal or pelvic surgery was in 42.1% and tubal sterilization was in 14.1%, pelvic inflammatory disease was in 8.3%. Hemoglobin value over 10.0 gm/dl was in 79.2% and below 8.0 gm/dl in 4.5%. Initial systolic blood pressure risen above 100mmHg was in 79.0%. The most frequent intervals between last menstrual period and the onset of symptom was 6~8 weeks in 56.0%. The clinical manifestations were appeared in 78.8% from the last menstrual period to the next 4~8 weeks. In clinical symptoms, amenorrhea was encountered in 91.7%, lower abdominal pain in 88.3% and vaginal spotting in 47.3%. Ectopic gestation was implanted on the fallopian tube in 97.1%, the ovary in 1.1%, the cervix in 0.7%, the intraabdominal in 0.9% and 1 case was intramural pregnancy. Total amount of intraperitoneal hemorrhage between 100-999ml was in 59.5%, above 1,000ml in 37.5% and less than 100 ml in 3.0%. Of total 448 cases, laparotomy was done in 229 cases(51.0%) and pelvisopic surgery in 219 cases(49.0%). The mean hospital stay was 3.1 days in pelviscopy procedure and 5.0 days in laparotomy. The operative precedures were salpingectomy in 87.5%, salpingo-oophorectomy in 4.9%, cornual resection in 6.3%, ovarian wedge resection in 0.7%, and oophorectomy in 0.2%. There was no dead case in all ectopic pregnancy. Average admission period after laparoscopy was 3.1 day and after laparotomy was 5.0 day. CONCLUSION: The cognizing of increasing incidence of ectopic pregnancy, early diagnosis and early treatment is presumed to decrease mortality and increase fertility. The successful treatment and decision is a challenge to the clinician who must consider the patient's needs with appropriate tactfulness.