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Korean Journal of Obstetrics & Gynecology 1998;41(7):1889-1895.
Published online January 1, 2001.
A Clinical Study on 48 Cases of Interstitial Tubal Pregnancy.
M Y Woo, W S An, J H Kim, K J Kim, J S Park
Abstract
Ectopic pregnancy continues to be a leading cause of maternal morbidity and of reduced childbearing potential among women of reproductive age. Because of tubal rupture, it is still the main cause of pregnancy-related death during the first trimester, especially interstial tubal pregancy. The incidence of interstitial tubal pregnancy accounts for approximately 2 to 6 percentes and has been on the increase, and a rise in the proportion on unruptured tubal pregnancy has been reported. This change in presetation calls for a new approach. We experienced 814 cases of ectopic pregnancies. Among these, this study was undertaken for the clinical evaluation and statistical analysis on 48 patients with interstitial tubal preganancy who has been admitted and treated at Eul Ji medical center from January 1 1992 to June 30 1997. And we present the results of pelviscopic ligation with local methotrexate injection. The results of the study were as follows ; 1. The total number of ectopic pregnancies were 814 cases and among these interstitial pregnancies were 48 cases. The incidence was 5.9%. 2. The distribution of age was 18 to 45 years and the frequent age group was 31~35 years. 3. Women that had two deliveries were 22 cases (45.8%), and nullipara was 16 cases (33.3%). 4. Women that experienced one or more abortions were 41 cases (85.4%), and no history of abortion was 7 cases (14.6%). 5. In the past history, PID in 10 cases (20.9%), previous adnexal operation in 6 cases (12.5%), and previous IUD use in 5 cases (10.4%). 6. The number of cases experiencing previous ectopic pregnancy were 4 cases (8.3%). 7. The clinical manifestation appeared in 39.6% from last menstrual period to the next 6~8 wks. 8. On symtomatological analysis, lower abdominal pain and discomfort was encountered in 58.3%, amenorrhea in 20.8%, and vaginal spotting in 16.7%. 9. In unruptured group, the size of ectopic focus was above 10 cm in 10 cases (42%), 8~9 cm in 7 cases (29%), and 6~7 cm in 3 cases (13%). 10. The diagnostic positive rate was 73% in sonogram. 11. Among 48 cases, we conducted cornual resection in 39 cases and pelviscopic ligation with local methotrexate injection in 9 cases. 12. In pelviscopic ligation and local methotrexate injection group, the median resolution time was 7.9 days and successful rate was 100%. 13. There were no complications except transfusion.
Key Words: Interstitial pregnancy, Laparoscopic ligation


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