The Comparison Of Subsequent Reproductive Outcomes Among Different Conservative Treatments Of Tubal Pregnancy

ObjectiveThis topic, through the retrospective study, analyzed the influence of conservative treatment for tubal pregnancy after fertility outcome, and analyzed the factors that affect fertility outcome after treatment, compared different treatment effects of tubal patency of the situation, in order to provide guidance for tubal pregnancy.MethodsWith retrospective method retrospectively collected from 2009 to 2015 for tubal pregnancy in patients who underwent conservative treatment, which records patient’s relevant medical history main including basic information, history characteristics, (such as past medical history, history of gestation), hospitalization, auxiliary examination, treatment methods, fertility condition of follow-up of 1 year or more, tubal patency... Input the collected data into SPSS22 for statistical analysis.Results1.The treatment methods of tubal pregnancy:1531 patients with tubal pregnancy has been treated in our hospital since 2009-2015,55% of which is conservative treatment; 45% of which is surgical treatment, there was no obvious difference among three years treatment of tubal pregnancy (P> 0.05).2. Compareing hospitalization days and the hospitalization cost:tubal pregnancy patients with different treatments, the hospitalization days and the hospitalization cost difference, the hospitalization days of Laparoscopic surgical cutting tube in embryo is shortest.hospitalization costs of medicine conservative treatment group is cheapest.3. Fertility outcome after treatmen:Follow-up of 121 patients with tubal pregnancy success. Chinese traditional medicine group of 30 cases, western medicine group of 25 cases, Combine traditional Chinese and western medicine group of 35 cases, laparoscopic tubal fenestration group of 31 cases. chinese medicine treatment group intrauterine pregnancy rate is 67.0%(20 cases),western medicine treatment group is 48%(12 cases), combining Chinese and western medicine treatment group is 69%(24 cases), laparoscopic tubal fenestration group is 61%(19 cases). There was no obvious difference between the four groups (P>0.05). The recurrent EP ratesof chinese medicine treatment group, western medicine treatment group, combining Chinese and western medicine treatment group, laparoscopic tubal fenestration group is 10%、 38%、11%、29%, There was obvious difference between the four groups (P< 0.05). The infertility rate of chinese medicine treatment group,western medicine treatment group, combining Chinese and western medicine treatment group, laparoscopic tubal fenestration group is 23%、16%、20%、10%, there was no obvious difference between the four groups (P>0.05).4. Intrauterine pregnancy in different period:intrauterine pregnancy after treatment,75 cases is uterine pregnancy。including one year of intrauterine pregnancy 41 cases (55%), intrauterine pregnancy within 2 years, 69 patients (92%),3-5 years intrauterine pregnancy 6 cases (8%), indicating that 2 years after tubal pregnancy is the best time to conceive. There was no significant difference (P>0.05) among the four groups in different periods of intrauterine pregnancy.5. Fallopian tube patency:patients with tubal pregnancy conservative treatment after 3-6 months there are 57 cases were examined by fallopian tube radiography, ipsilateral fallopian tube patency rate of Chinese medicine group was 87%(13 cases), the other side is 93%(14 cases); ipsilateral fallopian tube patency rate of western medicine treatment group was 70% (7 cases), the other side is 80%(8 cases); ipsilateral fallopian tube patency rate of combining Chinese and western medicine treatment group was 88%(15 cases), the other sideis 82%(14 cases); ipsilateral fallopian tube patency rate of laparoscopic tubal fenestration group was 47%(7 cases), the other side is 80%(12 cases), ipsilateral fallopian tube patency rate of the four grop is obvious difference (P<0.05), while the other side is unsignificant (P>0.05).6. Factors that affect fertility outcome after treatment:age, pelvic inflammatory disease, infertility, history of ectopic pregnancy is the main factors which affect fertility outcome.conclusionschinese medicine treatment and combining Chinese and western medicine treatment have a unique advantage in reducing ectopic re-pregnancy rate and improving tubal patency rate. When strictly grasp the indications of drug treatment, which can use Chinese medicine therapy or combine traditional Chinese and western medicine treatment to protect the patient’s fertility. our analysis indicates that subsequent fertility depends more on the patients previous medical history than on her treatment for EP.