| Objective:This study aimed to investigate the characteristics and clarify the independent risk factors of ectopic pregnancy in the Grade III-A Hospitals of Hebei province,thus provides the basis for the disease prevention and the treatment.Methods:This study was designed as case series analysis and case control study.Firstly,selected four Grade III-A hospitals in Hebei province randomly.Clinical records including pregnancy site,age,marital status,pregnancy history and related medical history of 1760 patients with ectopic pregnancy who were hospitalized in four hospitals from 2015 to 2017 were collected to investigate the prevalence and related factors of ectopic pregnancy.Then,251 patients with ectopic pregnancy who met the inclusion and exclusion criteria admitted to the same four hospitals from January to May 2018 were selected as the case group.At the same time,251 normal intrauterine pregnancy women admitted to the same hospital in the same period were randomly selected according to 1:1 ratio as the control group.The demographic data,pregnancy history,contraceptives history,past and present medical history,mental health status of two groups were investigated by a self-designed questionnaire on risk factors related to ectopic pregnancy.Finally,independent risk factors of ectopic pregnancy were further discussed by using SPSS software through univariate analysis and multivariate logistic regression analysis.Results:1.The result of case series analysis:(1)The overall prevalence rate of ectopic pregnancy was 4.68%.(2)During the three years,the average age of onset of ectopic pregnancy increased year by year,and the difference was statistically significant(P<0.05).The overall peak age ranged from 25 to 39 years old,accounting for 78.7% of all cases.(3)During the three years,the previous average pregnancy frequency of patients with ectopic pregnancy increased year by year,and the difference was statistically significant(P<0.05);The proportion of those with two or more previous vaginal deliveries,two or more previous cesarean sections and two or more previous miscarriages was on the rise;(4)The occurrence of ectopic pregnancy is related to age,number of previous pregnancies,history of pelvic and abdominal surgery,history of cesarean section and pelvic inflammatory disease.2.The result of case control study: In both univariate and multivariate logistic regression analyses,pelvic inflammatory disease(OR=3.976,P=0.000),recurrent ectopic pregnancy(OR=2.425,P=0.017),history of cesarean section(OR=2.059,P=0.003),history of previous pregnancies,the age of first pregnancy is less than 22 years(OR=2.002,P=0.003)and emotional volatility(OR=1.274,P=0.032)were the independent risk factors of ectopic pregnancy.Conclusions:1.The prevalence rate of ectopic pregnancy was 4.68% overall;the age of onset and the number of previous pregnancies increased gradually,and the peak age group had a delayed trend.Therefore,women whose age between 25 and 39 years old and have multiple pregnancies,once pregnancy,should pay more attention to be vigilant about the occurrence of ectopic pregnancy.2.The occurrence of ectopic pregnancy is the result of multiple factors.Therefore,it is necessary for adolescent women to strengthen the correct concept of marriage,to reduce the number of accidental pregnancies and the harm of the young age of first pregnancy;The indication of cesarean section should be strictly controlled and perinatal management and prenatal education are needed in order to reduce the rate of cesarean section,so as to reduce the pelvic inflammatory disease;Appropriate psych--ological care is needed to help childbearing women learn to regulate their emotions,so as to reduce the occurrence of ectopic pregnancy. |
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