The Changes Of The Risk Factors Of Tubal Pregnancy In Recent Years And The Retrospective Study Of Expectant Management Of Tubal Pregnancy:the Prediction Of The Successful Outcome Came To Light

Objective①.To investigate the changes of the risk factors of tuba] pregnancy in recent years.②. The relative factorts were analysised to slect patients of tubal pregnancy for expectant management, providing a theoretical basis for clinical treatment.Methods①.Retrospective analysis of the relative factors was conducted between432cases of EP in2004-2006and382cases in2009-2011,including age, occupation, marital status, pregnancy history and past history.②. Retrospective analysis of the relative factors of180cases of tubal pregnancy with expectant management in Department of Family Planning of Cheeloo Hospital from August,2004to January,2012was conducted, including general clinical data, clinical manifestations and laboratory tests, the cases which did not need Surgery or Drug therapy were belong to the cured group, the rest were the failure group.Results①. The composition of the unmarried patients increased from12.03%to19.63%(P=0.003) while the composition of the mulliparous patients increased from33.10%to41.10%(P<0.001),The proportion of the patients with history of abortion decreased from67.59%to53.40%(P<0.001), the proportion with the history of cesarean section increased from7.64%to14.90%(P<0.001), the proportion with history of infertility increased by6.48%to8.38%(P=0.022); Proportion of IUD insertion dropped from16.44%to5.50%(P<0.001);The ratio of pelvic inflammatory disease increased from10.18%to14.66%(P=0.049), the proportion of history of pelvic surgery decreased from20.6%to14.92%(P=0.027).②.140of180cases of tubal pregnancy with expectant management were successfully managed, the cure rate is75.27%; It has no significant between the cured group and the failure group (P>0.05) in the size of the mass under Ultrasonography; The case with gestational sac of the mass under Ultrasonography has static difference between two groups (P<0.05);It has static difference between two groups (P<0.01) in the initial blood β-hCG, the initial blood β-hCG and D3～5/D0(the ratio of blood β-hCG between3～5day and the initial) are the variables for predicting the likelihood of successful expectant management under the ROC curve, The Youden Index is the largest when the initial blood β-hCG is634IU/L or D3～5/D0is0.711.Conclusion①.The preventive measures should be made for the changes of the relative factors to reduce The incidence of Tubal pregnancy.②. When β-hCG of blood≤634IU/L or D3～5/D0=0.711,expectant management can be given. The mass with gestational sac under Ultrasonography is the relative factor of expectant management.