The Risk Factors Of Recurrent Tubal Pregnancy: A Case-control Study

Objective:Tubal pregnancy is one of the most common acute abdomen in gynecology and obstetrics.Its incidence rate has increased in recent years.Recurrent tubal is one of the long-term adverse pregnancy outcomes of tubal pregnancy,which seriously affects the health and quality of life of patients with previous tubal pregnancy.Through retrospective case-control analysis,this study studied the related high-risk factors and clinical characteristics of recurrent tubal pregnancy,so as to provide a more comprehensive and scientific theoretical basis for the diagnosis and treatment of Obstetricians and gynaecologists,in order to expect effective intervention and guidance for patients with previous tubal pregnancy,reduce the risk of reoccurrence,and maximize the protection of women's long-term health Fertility.Methods:1.According to the inclusion and exclusion criteria,73 patients with recurrent tubal pregnancy were selected as the observation group(RTP group)and 146 patients with first tubal pregnancy as the control group(STP group).Among them,146 patients with STP were all followed up to September 2018 without reoccurrence of tubal pregnancy.2.The incidence factors and clinical characteristics of RTP group and STP group were recorded,followed up the two-year intrauterine pregnancy of RTP group and STP group,single factor analysis of the incidence factors,and statistical analysis of the clinical characteristics and intrauterine pregnancy of RTP group and STP group.3.Logistics regression analysis of high risk factors of repeated tubal pregnancy.Results:1.There was no significant difference between RTP group and STP group(54.11% vs 47.95%,P > 0.05).2.Analysis of the clinical characteristics of RTP group and STP group: in RTP group,the diameter of ultrasound mass > 4cm was less than that of STP group,and the incidence of pelvic adhesion was higher than that of STP group(P > 0.05).3.Single factor analysis of recurrent tubal pregnancy:birth history,pelvic surgery history,previous treatment of tubal pregnancy were statistically significant(P < 0.05);age,education level,smoking history,pregnancy history,abortion history,endometriosis history,pregnancy mode,tubal pregnancy site,previous treatment of tubal pregnancy were not statistically significant(P >0.05).4.Multiple logistic regression analysis: the high risk factors of recurrent tubal pregnancy were the history of pelvic surgery(OR=13.973,95% CI = 6.674-29.257)and the previous open treatment of tubal pregnancy(OR=8.139,95%CI=2.086-31.751).Conclusion:1.The diameter of ultrasound mass > 4cm in the reurrent tubal pregnancy group was significantly less than that in the first tubal pregnancy group,while the incidence of pelvic adhesion was significantly higher than that in the first tubal pregnancy group.There was no significant difference between the two groups in the time of menopause,abdominal pain,vaginal bleeding and the highest value of h CG before operation.2.The high risk factors of recurrent tubal pregnancy were the history of pelvic surgery and the way of laparotomy.