Trends in the Treatment and Clinical Presentations of Tubal Ectopic Pregnancy in Imam Reza Hospital of Kermanshah, Iran (2007-2011)

Document Type : Original Article


1 Assistant Professor, Department of Obstetrics and Gynecology, Maternity Research Center, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

2 General Physician, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

3 Assistant Professor, Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

4 B.Sc. Student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.


Introduction: 1.2-1.4% of all reported pregnancies are ectopic. Ectopic pregnancy (EP) constitutes a major cause of maternal mortality in the first trimester of pregnancy and its incidence is increasing. The aim of this study was to evaluate the trends in management and clinical presentations of tubal ectopic pregnancy.
Methods: This descriptive-analytical study was conducted on women with tubal ectopic pregnancy who referred to Imam Reza hospital of Kermanshah, Iran during 2007-2011. Demographic information and variables such as maternal age, gestational age, gravidity and parity were collected. Data were analyzed by SPSS software version 16, chi-square, Kolmogorov-Smirnov, ANOVA and Kruskal–Wallis. P value less than 0.05 was considered significant.
Results: The most frequent ectopic pregnancy was observed in the 26-30 years age group. The most of the EP were admitted in 2011 (29%) and the least were in 2007 (15.5%). 228 patients (57%) were multiparous and thee mean of gestational age was 6.52±2.72 weeks. The most common clinical presentation was abdominal pain (74.0%) and then vaginal bleeding, amenorrhea and shock, respectively. The variables of trends in treatment (p=0.001) and bleeding (p=0.03) were statistically significant during the 5 years of study. The most common site of EP was in ampulla (50.0%) and 227 patients (56.8%) were treated surgically. The most common method of surgery was salpingectomy (75.8%). 49.1% of patients was treated with a single-dose methotrexate protocol were applied.
Conclusion: The results showed that patients with EP have been rising during the period of study. The most common clinical presentation was abdominal pain and vaginal bleeding. Trends in the treatment were developed to increase using medical treatment and decrease in surgical treatment.


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