Ulus Travma Acil Cerrahi Derg. 2022; 28(11): 1604-1608 | DOI: 10.14744/tjtes.2021.93903

Akut batýn prezentasyonunda tubal ektopik gebelik: Bir olgu kontrol analizi

Banuhan Þahin¹, Andrea Tinelli^2
1Amasya Üniversitesi Sabuncuoðlu Þerefeddin Eðitim ve Araþtýrma Hastanesi, Kadýn Hastalýklarý ve Doðum Anabilim Dalý, Amasya
²Verisdelli Ponti Hastanesi, Kadýn Hastalýklarý ve Doðum Anabilim Dalý, Lecce-Ýtalya

AMAÇ: Klinik prezentasyonu akut batýnla veya akut batýn olmadan gerçekleþen tubal gebeliklerin (TG) demografik verileri, klinik bulgularý, ektopik gebelik (EG) lokalizasyonunu (sol veya sað taraflý) ve tedavilerini deðerlendirmek.
GEREÇ VE YÖNTEM: Tubal gebelik tanýlý gebeler akut batýn olsun veya olmasýn, EG lokalizasyonu (sað/sol), yaþ, parite, semptomlar (adet gecikmesi, vajinal kanama, kasýk aðrýsý), baþlangýç β-hCG deðeri, endometriyal kalýnlýk, rüptür varlýðý ve tedavi tipi (metotreksat, cerrahi) açýsýndan deðerlendirilmiþ ve karþýlaþtýrýlmýþtýr.
BULGULAR: Toplam 122 TG’li gebenin 32’si akut batýn göstermekteydi, 45’inin sað tüpünde ve 32’sinin sol tüpünde TG mevcuttu. Akut batýn grubunda parite, baþlangýç β-hCG düzeyi ve endometrial kalýnlýk akut batýn olmayan gruba göre daha fazlaydý. Buna ek olarak, akut batýn olmayan gruba göre kanama þikayetlerinin sýklýðý, sað taraflý TG olma, rüptür durumu ve ameliyat gerekliliði daha yüksekti. Sol taraflý TG olanlarda geçirilmiþ EG ve metotreksat tedavi sýklýðý, sað taraflý TG olanlara göre daha yüksekti.
TARTIÞMA: Acil servise akut batýn semptomlarý ile baþvuran TG’li hastalardaki EG, çoðunlukla sað tüpte yerleþmiþ olup daha fazla sýklýkta açýk cerrahi yoluyla salpenjektomiyi gerektirir.

Anahtar Kelimeler: Akut batýn, ektopik gebelik, metotreksat, salpenjektomi; tubal gebelik.

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Tubal ectopic pregnancy in acute abdominal presentation: A case control analysis

Banuhan Þahin¹, Andrea Tinelli^2
1Department of Gynecology and Obstetrics, Amasya University Sabuncuoðlu Þerefeddin Training and Research Hospital, Amasya-Türkiye
²Department of Gynecology and Obstetrics, Verisdelli Ponti Hospital, Lecce-Italy

BACKGROUND: The aim of the study was to evaluate the demographic data, clinical findings, ectopic pregnancy (EP) localization (left or right-sided), and treatments versus clinical presentation of tubal pregnancies (TP) with or without acute abdomen.
METHODS: Pregnants with a diagnosis of TP, selected for acute abdomen or not, were evaluated and compared, concerning EP local-ization (right/left), age, parity, symptoms (menstrual delay, vaginal bleeding, and groin pain), initial β-hCG value, endometrial thickness, presence of rupture, and treatment type (methotrexate and surgery).
RESULTS: On a total of 122 pregnants with TP, 32 showed acute abdomen, 45 had a TP located in the right tube and 32 in the left tube. In the acute abdomen group, parity, initial β-hCG level, and endometrial thickness were greater than non-acute abdomen group. In addition to this, the frequency of bleeding complaints, right-sided TP, rupture, and need for surgery were higher, than to the non-acute abdomen group. The frequency of the previous EP and methotrexate treatment was higher in those with the left-sided TP compared to those with the right-sided TP.
CONCLUSION: EP rate, in patients with TP who applied to the emergency department with acute abdominal symptoms, was mostly located in the right tube with greater frequency of salpingectomy in open surgery.

Keywords: Acute abdomen, ectopic pregnancy, methotrexate, salpingectomy; tubal pregnancy.

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ATIF KOPYALA