Risk Factors And Prognosis Of Tubal Pregnancy

Objective:Tubal pregnancy is the means of zygote's implantation in the fallopian tubes,which is the acute abdominal pain common in our department of obstetrics and gynecology.Being about 98% of all Ectopic pregnancy,the tubal pregnancy became my focus.Althouth the The diagnosis and treatment becoming more efficient, made the improvement of the rate of survival and the fertility,but on account of increasing morbidity,the tubal pregnancy still making a threaten to woman.Achieve the investigation of disease risk factors,can targeted proceed prevention education for female in child bearing period,helping reduce the incidence rate. In the aspect of treatment,It's treatment is include medicine and operation,how about the efficacy? Our hospital still have no statistic research, through compare the descend level of human chorionic gonadotropin?length of stay and the cost, direct the best choice.Methods:Seek out all inpatients in hospital attached to Ningxia Medical University from January in 2010 to January in 2014 because of tubal pregnancy,all patients had the exact diagnosis,which treatment she had grouped her team:medicine ?conservative surgery and radical operation.with concurrent normal pregnancy group to be control group.All o the date were deal with SPSS 19.0, measurement data were expressed by mean and standard deviation, the enumeration data with the statistic analysis of chi-square test,to seek out the risk factor, follow-up the descend level of human chorionic gonadotropin ? length of stay and the cost,find out the best treatment.Select the patients who have the requirement of reproduction, follow-up their pregnancy-related conditions with their sex life without contraceptive in one year,it incorporate: normal pregnancy?ectopic re-pregnancy and sterility.Result:1. High incidence of age of tubal pregnancy range between 20-40 years old,accounts for 92.5%;2.Results of univariate analysis:The differences of abortion history?intrauterine device?scarred uterus?a history of pelvic inflammatory and pelvic surgery between tubal pregnant patients and normal pregnant patients were statistically significant(P<0.05).The differences of naton?cultural levels?paramenia?toxic exposure history?smoking history?rinking?uterine cavity?endometrial polyp ?endometriosis?ovarian tumor ? assisted reproduction technology and oral contraceptive were no significant(P>0.05).3.Results of multi-factor Logistic regression analysis: a history of pelvic inflammatory and pelvic surgery,and intrauterine device are the risk factors that exist independently.Their OR value are 5.273?3.621 and 2.145 respectly.4.Their length of stay in each teams have no significant differences(P>0.05).5. treatment charge: The average cost is 3638.69±20.66 yuan by medicine, 7163.93±47.73 yuan by conservative surgery and 8444.83±275.66 yuan by radical operation respectly. F=39.75,P<0.05,consider there are differences between these three teams. pairwise comparison by SNK test,agree the cost by medicine are cheaper than both conservative surgery and radical operation,there's no significant different between conservative surgery and radical operation. 6. there are no differences between these three teams in descend level of human chorionic gonadotropin three days and one week after their theatment. 7.The pregnant rate in medicine?conservative surgery and radical operation are 58.2%?49%?39.2% respectly,and with no significant differences(P>0.05);the ectopic re-pregnancy rate are 10.9%?4.6%?21.6% respectly,the rate in conservative surgery team are lower than both madicine and radical operation team(P<0.05);the sterility rate are 30.9%?46.4%?39.2% respectly, with no significant differences(P>0.05).Conclusion:1. High incidence of age of tubal pregnancy range between 20-40 years old,doctors should think of it when acute abdominal pain patients admission.2.Tubal pregnancy is related to abortion history?intrauterine device?scarred uterus?a history of pelvic inflammatory and pelvic surgery.3. Medicine have the higher cost performance in the treatment of tubal pregnancy.4. The conservative surgery are fit with the patients who have the requirement of reproduction when there are no contraindication.