PDF(Pubmed)
Abstract：
BACKGROUND: Interstitial pregnancy may still happen even after ipsilateral salpingectomy, resulting in massive hemorrhage. Therefore, the purpose of the study is to identify risk factors associated with interstitial pregnancy following ipsilateral salpingectomy and discuss possible prevention.
METHODS: We conducted a retrospective cohort study in a single, large, university-affiliated hospital. Data of 29 patients diagnosed with interstitial pregnancy following ipsilateral salpingectomy from January 2011 to November 2020 were assigned into the case group (IP group). Whereas there were 6151 patients with intrauterine pregnancy after unilateral salpingectomy in the same period. A sample size of 87 control patients was calculated to achieve statistical power (99.9%) and an α of 0.05. The age, BMI and previous salpingectomy side between the two group were adjusted with PSM at a ratio of 1:3. After PSM, 87 intrauterine pregnancy patients were successfully matched to 29 IP patients.
RESULTS: After PSM, parous women were more common and intrauterine operation was more frequent in the IP group compared with control group (P<0.05). There was only one patient undergoing IVF-ET in the IP group as compared with 29 cases in the control group (3.4% vs. 33.3%, P<0.05). Salpingectomy was performed on 5 patients in the IP group and 4 patients in the control group due to hydrosalpinx (P<0.05). Logistic regression indicated that hydrosalpinx was the high risk factor of interstitial pregnancy following ipsilateral salpingectomy (OR = 8.175).
CONCLUSIONS: Hydrosalpinx appears to be an independent factor contributing to interstitial pregnancy following ipsilateral salpingectomy in subsequent pregnancy.
METHODS: We conducted a retrospective cohort study in a single, large, university-affiliated hospital. Data of 29 patients diagnosed with interstitial pregnancy following ipsilateral salpingectomy from January 2011 to November 2020 were assigned into the case group (IP group). Whereas there were 6151 patients with intrauterine pregnancy after unilateral salpingectomy in the same period. A sample size of 87 control patients was calculated to achieve statistical power (99.9%) and an α of 0.05. The age, BMI and previous salpingectomy side between the two group were adjusted with PSM at a ratio of 1:3. After PSM, 87 intrauterine pregnancy patients were successfully matched to 29 IP patients.
RESULTS: After PSM, parous women were more common and intrauterine operation was more frequent in the IP group compared with control group (P<0.05). There was only one patient undergoing IVF-ET in the IP group as compared with 29 cases in the control group (3.4% vs. 33.3%, P<0.05). Salpingectomy was performed on 5 patients in the IP group and 4 patients in the control group due to hydrosalpinx (P<0.05). Logistic regression indicated that hydrosalpinx was the high risk factor of interstitial pregnancy following ipsilateral salpingectomy (OR = 8.175).
CONCLUSIONS: Hydrosalpinx appears to be an independent factor contributing to interstitial pregnancy following ipsilateral salpingectomy in subsequent pregnancy.
摘要：
背景：即使在同侧输卵管切除术后，间质性妊娠仍可能发生，导致大出血.因此,本研究的目的是确定与同侧输卵管切除术后间质妊娠相关的危险因素，并讨论可能的预防措施。
方法：我们进行了一项回顾性队列研究，大,大学附属医院。将2011年1月至2020年11月诊断为同侧输卵管切除术后间质妊娠的29例患者分为病例组（IP组）。同期单侧输卵管切除术后宫内妊娠患者为6151例。计算87名对照患者的样本量以达到统计功效（99.9％）和0.05的α。年龄,用PSM以1：3的比例调整两组之间的BMI和先前的输卵管切除术。PSM之后,87例宫内妊娠患者与29例IP患者成功匹配。
结果：PSM后，与对照组相比，IP组产妇更常见，宫内手术更频繁（P<0.05）。IP组仅有1例患者接受IVF-ET，而对照组为29例(3.4%vs.33.3%,P<0.05)。IP组5例,对照组4例因输卵管积水行输卵管切除术(P<0.05)。Logistic回归分析显示输卵管积水是同侧输卵管切除术后间质妊娠的高危因素(OR=8.175)。
结论：输卵管积水似乎是导致同侧输卵管切除术后再次妊娠间质妊娠的独立因素。
方法：我们进行了一项回顾性队列研究，大,大学附属医院。将2011年1月至2020年11月诊断为同侧输卵管切除术后间质妊娠的29例患者分为病例组（IP组）。同期单侧输卵管切除术后宫内妊娠患者为6151例。计算87名对照患者的样本量以达到统计功效（99.9％）和0.05的α。年龄,用PSM以1：3的比例调整两组之间的BMI和先前的输卵管切除术。PSM之后,87例宫内妊娠患者与29例IP患者成功匹配。
结果：PSM后，与对照组相比，IP组产妇更常见，宫内手术更频繁（P<0.05）。IP组仅有1例患者接受IVF-ET，而对照组为29例(3.4%vs.33.3%,P<0.05)。IP组5例,对照组4例因输卵管积水行输卵管切除术(P<0.05)。Logistic回归分析显示输卵管积水是同侧输卵管切除术后间质妊娠的高危因素(OR=8.175)。
结论：输卵管积水似乎是导致同侧输卵管切除术后再次妊娠间质妊娠的独立因素。
