Document Detail

Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases.
MedLine Citation:
PMID:  12456628     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Several risk factors for ectopic pregnancy (EP) have been identified, but the site of implantation of EP has been little studied. METHODS: A total of 1800 surgically treated EP was registered between January 1992 and December 2001 in the Auvergne EP register and the women concerned were followed up. In this large population-based sample, we studied the distribution of EP sites, immediate complications, determining factors, and subsequent fertility. RESULTS: EP sites were interstitial (2.4%), isthmic (12.0%), ampullary (70.0%), fimbrial (11.1%), ovarian (3.2%) or abdominal (1.3%). No cervical pregnancies were observed. Complications and treatment depended on the site of EP. In multivariate analysis, the only risk factor associated with EP site was current use of an intrauterine device (IUD), which was more frequent in distal EP. The 2 year cumulative rate of subsequent spontaneous intrauterine pregnancy (IUP) increased progressively from interstitial to ovarian EP. Fair concordance (weighted kappa = 0.31) was observed between the sites of two successive EP if they were homolateral. CONCLUSION: In addition to providing an accurate description of the sites of implantation of EP, this study shows that current IUD use 'protects' against interstitial pregnancies, which are the most difficult to manage. It shows that subsequent fertility tends to be higher in women with distal EP.
J Bouyer; J Coste; H Fernandez; J L Pouly; N Job-Spira
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  17     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-28     Completed Date:  2003-06-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  3224-30     Citation Subset:  IM    
INSERM U569-IFR69, Hôpital de Bicêtre, 82 avenue du Général Leclerc, 94276 Le Kremlin Bicêtre, France.
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MeSH Terms
Embryo Implantation
Infertility, Female / epidemiology,  etiology
Intrauterine Devices
Pregnancy, Abdominal / complications,  epidemiology,  surgery
Pregnancy, Ectopic* / complications,  pathology*,  surgery
Pregnancy, Tubal / complications,  epidemiology,  surgery

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