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Non-tubal ectopic pregnancy treatment experiences of a tertiary care center

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aim

To evaluate the incidence, the risk factors, and the treatment outcomes of Non-tubal ectopic pregnancies (NTEP) treated in a tertiary care center.

Material and methods

A total of 110 NTEP cases treated between 2014 and 2019 were included in the retrospective study. The study cohort was divided into 6 groups according to the pregnancy localization: 87 cesarean scar pregnancies (CSPs), 7 ovarian pregnancies, 6 interstitial pregnancies, 4 rudimentary horn pregnancies, 4 abdominal pregnancies, and 2 cervical pregnancies. One woman rejected all treatment modalities. Demographic characteristics, treatment modalities, and outcomes of each group were evaluated.

Results

In the study cohort, expectant management was performed in one (0.9%) woman. The methotrexate (MTX) treatment was administered in 29 (26.3%) women. Seventeen (15.4%) women underwent surgery, and 63 (57.2%) women underwent manual vacuum aspiration (MVA). A woman rejected all treatment modalities. Although 70.1% (n = 61) of CSPs were cured with MVA, 24.1% (n = 21) of them were treated with a single-dose MTX regimen in addition to MVA. The higher mean gestational sac size (33,9 ± 12,96 mm vs. 17,34 ± 9,87 mm), the higher mean gestational week (8,43 ± 1,16w vs. 6,66 ± 1,49w), the presence of fetal heartbeat (FHB) (90.5% vs. 26,2%) and the history of pelvic ınflammatory disease (PID) (38.1% vs. 6,6%) were found in the CSPs with MVA treatment failure (p < 0.05).

Conclusion

The management of NTEPs should be individualized according to the clinical and ultrasonographic findings. The size of the ectopic pregnancy mass, the gestational week, the presence of FHB, and the PID history were the predictive factors for the failure of MVA in CSP cases.

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Data availability

The data supporting this study is available through the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank all participants and their families who sacrificed their valuable time to participate in this study program. We would also like to thank the research team members for their tireless efforts.

Funding

There is no financial disclosure to be made for this study.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Maternity and Women’s Health Teaching and Research Hospital, Ankara, Turkey

    Yıldız Akdaş Reis, Arife Akay & Tuğba Kınay

  2. Bingöl Maternity and Children Hospital, Bingöl, Turkey

    Arife Akay

  3. Department of Perinatology, Etlik City Hospital, Ankara, Turkey

    Merve Özkan, Seval Yılmaz Ergani & Sadullah Özkan

  4. Department of Obstetrics and Gynecology, Bilkent City Hospital, Ankara, Turkey

    Salim Erkaya

Authors
  1. Yıldız Akdaş Reis
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  2. Arife Akay
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  3. Merve Özkan
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  4. Seval Yılmaz Ergani
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  5. Sadullah Özkan
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  6. Tuğba Kınay
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  7. Salim Erkaya
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Contributions

ARY: project development, data collection or management, manuscript writing/editing. AA: project development, data management, manuscript writing/editing. ÖM: data collection and management, project development. KT: data management, data analysis, project development, manuscript writing/editing. EYS, ÖS and SE: supervision, manuscript writing/editing.

Corresponding author

Correspondence to Yıldız Akdaş Reis.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

Ethics committee approval was taken for this retrospective study from the Local Ethics Committee.

Human rights

All authors and the study protocol have complied with the World Medical Association Declaration of Helsinki regarding the ethical conduct of research involving human subjects.

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Informed consent was obtained from patients who participated in this study.

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Akdaş Reis, Y., Akay, A., Özkan, M. et al. Non-tubal ectopic pregnancy treatment experiences of a tertiary care center. Arch Gynecol Obstet (2024). https://doi.org/10.1007/s00404-023-07338-5

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