Study On The Reproduction Of Tubal Pregnancy After Different Treatment

Objective:Ectopic pregnancy is a common gynecological acute abdomen,because of its high morbidity and mortality and further impact on reproduction,the physical and mental health of women were threatened,doctors and patients have been paid more and more attention on it.The rate of recurrent ectopic pregnancy is significantly increased in patients after first ectopic pregnancy,causing great pressure on the body and mind of the patient.The mainly ectopic pregnancy is tubal pregnancy.In this study,we mainly studied the reproduction of tubal pregnancy in two years after different treatment,including the drug conservative treatment,radical surgery and conservative surgery and the risk factors of recurrent tubal pregnancy.Method:1.Our study includes tubal pregnancy patients who were hospitalized in our hospital from September 2015 to October 2016.185 cases of first tubal pregnancy who have no child,73 cases of repeated tubal pregnancy patients(who were at least last hospitalized in our hospital).We follow these 185 patients for 2 years to analyze the situation of intrauterine pregnancy after different treatment methods.2.Through a retrospective case control study,we treated 73 cases of recurrent ectopic pregnancy as observation group,according to 1:2 proportion,we treated 146 cases of first tubal pregnancy as control group,none of the 146 patients had recurrent ectopic pregnancy until December 2018,analyze the risk factors of recurrent ectopic pregnancy.Result:1.Analysis of the results of pregnancy after the first ectopic pregnancy:among 185cases of ectopic pregnancy,18 cases were excluded and 167 cases remained,after two years follow-up of married first ectopic pregnancy patients who have no child.35 cases(20.96%)were treated conservatively,87 cases(52.10%)were treated by conservative operation,and45 cases(26.94%)were treated by radical operation.The intrauterine natural pregnancy rates of the three groups were 54.29%,49.43%,48.89%,respectively.The intrauterine natural pregnancy rates of the three groups were 54.29%,49.43%and 48.89%,respectively.There was no significant difference in pregnancy rate(?~2=0.285 P=0.867).The intrauterine pregnancy rates of the three groups were 71.43%,65.52%and 60.00%,respectively.There was no significant difference between the three groups(?~2=1.139 P=0.566).2.The results showed that the average age of patients with recurrent ectopic pregnancy was 31.10±4.44,and the average age of patients with first ectopic pregnancy was 29.29±4.41.?~2=2.84 P=0.005;The mean pregnancy history of recurrent ectopic pregnancy was2.38±1.16,the average pregnancy history of first ectopic pregnancy was 1.38±1.15,?~2=6.1P=0,between the tubal diseases t=23.11 P=0.008.Between the pelvic surgery,t=6.26,P=0.012.There was statistical difference between the two groups in the above analysis.On the other hand,in education(t=6.38 P=0.172),focus part(t=0 P=0.997),history of labor(t=1.517 P=0.131),history of miscarriage(t=0.624 P=0.264),assisted reproduction(t=1.590 P=0.208),treatment(t=4.304 P=0.116),There was no significant difference in preoperative hCG values(?~2=3.81 P=0.704).There was no statistical difference between the two groups in the above analysis.3.The result of single factor analysis of recurrent ectopic pregnancy:The P-value of age,history of pregnancy,fallopian tube disease,history of pelvic surgery,and pelvic adhesion were less than 0.05.For the above significant factors to do Logistic regression analysis,the pelvic surgery history and the pregnancy history enter the Logistic model.Conclusion:1.The reproduction after ectopic pregnancy:There was no significant difference in the rate of intrauterine pregnancy within two years after conservative treatment,conservative surgery and radical operation.2.pelvic surgery history and pregnancy history are the high risk factors for recurrent ectopic pregnancy.