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子宮外妊娠의 臨床統計的觀察

Ectopic Pregnancy

대한산부인과학회지 1965년 8권 12호 p.1 ~ 6
김선원,
소속 상세정보
김선원 (  ) - 서울대학교 의과대학 산부인과학교실

Abstract


From January 1962 to September 1965, two hundred and seventy three cases of ectopic pregnancies were treated at the Dept. of Obst. & Gynec. Seoul National University Hospital.
1) This series comprised of 250 tubal(99.6 %), and one ovarian(0.4 %) pregnancies.
2) During this same period, 3042 babies were delivered, giving a ratio of 1 to 11.14 live births(8.9 %)
3) The occurence was, high in August(15.14 %), low in october(1.95 %), and the rate of summer season doubled that of autumn season.
4) The mean age was 31.75 years, and 63.50 % of total were between 25 and 35 years of age.
5) Nulligravida was 14.74 %, nullipara 34.26 %, preimipara 14.3 %, and mutipara 47.4 % of total..
6) The last pregnancy ended in normal delivery in 47.41 %, artificial abortion in 38.25 % of total.
7) The duration of infertile period was 5 years and 5 months in nulligravida, 4 years and 5 months. in nullipara, & 4 years and 11 months in primigravida, giving a mean duration of 4 years and one. month; and 52.59 % of total was within 3 years, and 9.96 % over 10 years.
8) A history of previous abortion was noted in 50.2 % of total including 76.19 % of artificial abortion Among them, 21.83 % ended in ectopic pregnancies. 12.9 % of total cases had previous abdominal. surgery(53.85 % for eccyesis, 33.33 % for appendicitis). Tuberculosis was noted in 10.76 %, and venereal. diseases were detected in 9.96 % of total cases.
9) Lower abdominal pain was found in 99.20 %, abnormal uterine bleeding in 83.27 %, nausea and. vomiting in 33.47 %, shock in 31.47 %, bowel and urinary symptoms as tenesmus or rectal pain in. 25.10 %, subjective symptoms of pregnancy in 7.98 % , and shoulder pain in 1.59 % of total cases.
10) Adnexal mass, usually tender, was palpated in 76.89 %, and lowerab dominal tenderness was noted, in 75.70 % ; 59.36 % of total cases complained of pain on motion of cervix, and 32.20 % of total cases had a tender or bulged posterior fornix of cervix. Mass in the Cul-de-Sac was palpated in 6.7 % of total cases.
11) Lower abdominal pain and abnormal uterine bleeding were present in 91.25 % of total cases, and, bleeding preceeded pain in 45 % of the total, the reverse being 33.82 % . The mean duration of the above symptoms from the begining of l.m.p. was 3504 days, 33.82 days, and 40.69 days respectively. As. a whole the duration was between 31-50 days in 46.62 % of total. In the cases of rupture pain usually preceeded(41.18 %), and aborted cases, bleedinhg preceeded(36.52 %).
12) The initial diagnosis was correct in 89.4 % of the total cases. Diagnosis was wrong in 4.56 % of total preoperatively, and 5.62 % of the total after operation.
13) Culdocentesis was accurate in 98.6 % of the total trial.
14) 51.05 % of the total gestations occured on the right side of the tube. The fimbrlal portion was involved in 9.16 %, ampullary portion in 72.11 and the isthmic portion was involved in 14.7 %, of the total gestations. The Interstitial pregnancy was 3.60 % of the total. Tubal Abortion was present in 45.92 % of the total gestations, and rupture was noted in 54.18 %.
15) Adnectomy was performed in 32.67 %, conservative plastic operations in 7.17 % of the total cases. 60.20 % of the cases were treated with salpingectomy only.
16) Of 273 total cases, no death occurred.

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