Dergiler / GORM:Gynecology Obstetrics & Reproductive Medicine / 2001 / Cilt: 7 - Sayı: 2
Intrauterine device and ectopic pregnancy: A risk evaluation
- Sayfa
- 109–113
- DOI
- —
Özet
Bu çalışma rahim içi araçlarla ektopik gebelik ilişkisini araştırmak amacıyla planlanmıştır. Toplam 198 tubal ektopik gebelik olgusu , fertil çağda ve ektopik gebelik öyküsü olmayan 537 sağlıklı kadınla karşılaştırılmıştır. Ektopik gebelik öyküsü olan kadınlarda indüklenmiş ve spontan abortus sayıları anlamlı olarak yüksek bulunmuştur. Lojistik regresyon modeline dahil edilen geçirilmiş alt abdominal bölge operasyonu, bilateral tüp ligasyonu , ovulasyon indüksiyonu , spontan abortus, indüklenmiş abortus, pelvik inflammatuar hastalık ve rahim içi araç kullanımı değişkenlerinden rahim içi araç kullanımının ektopik gebelik riskini azalttığı, geçirilmiş pelvik inflammatuar hastalığın ve spontan abotusun riski arttırdığı bulunmuştur.
Abstract
OBJECTIVE: To evaluate the association between tubal ectopic pregnancy and eight potential risk factors. STUDY DESIGN: Cases were 198 women with confirmed diagnosis of tubal ectopic pregnancies who were hospitalized at our institution between 1996 and 1999. Controls were 537 randomly selected age-matched, healthy, sexually active enrollees with no history of suspected or known ectopic pregnancy. Potential risk factors: history of spontaneous abortion, dilatation and curettage, pelvic inflammatory disease, ovulation induction, previous surgical lower abdominal intervention, tubal ligation, current intrauterine device (IUD) use and cigarette smoking were recorded in both groups. A logistic regression model was used to calculate the odd ratios of the proposed risk factors. RESULTS: The mean age of ectopic pregnancy group was 29.3±5.2 years and 28.6±6.8 in the control group (t =1.2, p=0.2) intrauterine device was present in 19.1% of ectopic pregnancy group (n = 38) and 32.0 % of the control group (n = 178, p< 0.001). Analysis of the obstetric history of both groups revealed no difference in gravidity, parity and number of live birth (p= 0.2, p= 0.1, p= 0.1 respectively), while induced and spontaneous abortions were found to be more common in ectopic pregnancy group (t = -2.5, p:0. 01; t = -3.3, P = 0.001 respectively). Current IUD use was found to decrease ectopic pregnancy risk (OR =0.49, 95 % CI: 0.33-0.74). History of pelvic inflammatory disease (OR = 3.0, CI = 1.5 -5.7) and history of spontaneous abortion in contrast increased the risk (OR = 1.8, CI = 1.2 - 2.6). CONCLUSION: Current IUD use maintains 51 % protection against ectopic pregnancy. (Gynecol Obstet Reprod Med 2001; 7:109-113)