Ectopic pregnancies: a retrospective cohort analysis in a tertiary reference center in the Northeast Region of Brazil.
Ceska Gynekol
; 83(6): 434-439, 2018.
Article
em En
| MEDLINE
| ID: mdl-30848148
ABSTRACT
OBJECTIVE:
The objective of this study was to investigate the clinical and epidemiological characteristics of patients with ectopic pregnancy admitted to a tertiary center in the Northeast Region of Brazil and the aspects related to the treatment and outcomes in these women.DESIGN:
This was a retrospective cohort study of 101 patients diagnosed with ectopic pregnancy between February 2016 and February 2017.SETTING:
Assis Chateaubriand Maternity School, Fortaleza, Ceará, BrazilMethods:
The data collected included demographic characteristics, gynecological-obstetric history, symptoms at admission, complementary examinations [chorionic gonadotropin (β-hCG) blood test, transvaginal ultrasound, and hemoglobin level], and treatment given.RESULTS:
The mean patient age was 28 ± 6.6 years (14-48 years). Abdominal pain (96%) and vaginal bleeding (82.4%) were the most prevalent symptoms. No risk factors were identified in most of the patients (53.5%), whereas the most frequently identified risk factor (16.9%) was a history of previous ectopic pregnancy. At admission, 63.4% of patients presented ruptured ectopic pregnancy and 5.9% had hemodynamic instability. Among the patients with ruptured ectopic pregnancy, 61% had already sought care at another center. With regard to the therapeutic options, 78.2% underwent surgery (27.2%, laparoscopy), 16.8% used methotrexate (MTX), and 5% underwent expectant management. Among those who received MTX, 41.2% needed subsequent surgery because of elevated blood β-hCG level (57.1%) and clinical signs of ruptured ectopic pregnancy (42.9%).CONCLUSION:
The patients were admitted at an advanced stage of ectopic pregnancy, which made a more conservative and less costly treatment difficult. However, the outcomes were clinically satisfactory, with low complication rates and no maternal deaths. Keywords ectopic pregnancy, methotrexate, epidemiology, laparoscopy, laparotomy.Palavras-chave
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Bases de dados:
MEDLINE
Assunto principal:
Gravidez Ectópica
/
Hemorragia Uterina
/
Dor Abdominal
/
Metotrexato
/
Gonadotropina Coriônica Humana Subunidade beta
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Ceska Gynekol
Assunto da revista:
GINECOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article