Management of various types of ectopic pregnancy - a questionnaire study.

IF 0.5 Q4 OBSTETRICS & GYNECOLOGY
Barbora Švédová, Martin Hruda, Vít Drochýtek, Michael Jiří Halaška, Kateřina Maxová, Nikola Janovská, Helena Součková, Anna Babková, Lukáš Rob, Borek Sehnal
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Abstract

Objective: To map management of different types of ectopic pregnancies in the Czech Republic using a questionnaire-based study.

Methods: In 2023, a total of 95 obstetrics and gynecology departments across the Czech Republic were surveyed using an online questionnaire, which inquired about the management strategies for various types of ectopic pregnancies. The departments were categorized based on the number of hysterectomies performed annually. Differences in responses between large centers and other departments were statistically compared.

Results: A total of 45 departments of all sizes completed the questionnaire. Two-thirds of all departments always perform salpingectomy in cases of tubal pregnancy (78% of large, 58% of medium-sized, and 40% of small departments). Systemic methotrexate administration for the treatment of intact tubal pregnancy is used by one-fifth of departments (22% of large, 23% of medium-sized, and 0% of small departments). In cases of atypical ectopic pregnancy localization, methotrexate treatment is used by 33% of large, 42% of medium-sized, and 40% of small departments. A statistically significant difference was observed in the clearly preferred laparoscopic approach for surgical management of cesarean scar pregnancy in large centers compared to smaller departments (P = 0.036). No other statistically significant differences were observed between the departments in other parameters.

Conclusion: In cases of intact tubal pregnancy, four-fifths of obstetric and gynecological departments perform laparoscopic salpingectomy, while only one-fifth utilize systemic methotrexate for treatment. On the other hand, methotrexate is used by one-third to two-fifths of departments of all sizes in cases of atypical ectopic pregnancy localization.

不同类型异位妊娠的处理-一项问卷调查研究。
目的:通过一项基于问卷的研究,了解捷克共和国不同类型异位妊娠的管理情况。方法:于2023年对捷克95家妇产科进行在线问卷调查,了解不同类型异位妊娠的处理策略。科室根据每年子宫切除术的数量进行分类。对大型中心与其他科室的反应差异进行统计学比较。结果:共有45个大小院系完成问卷。三分之二的科室(大科室78%,中科室58%,小科室40%)对输卵管妊娠患者均行输卵管切除术。五分之一的科室(22%的大型科室,23%的中型科室,0%的小型科室)使用甲氨蝶呤系统治疗完整输卵管妊娠。在非典型异位妊娠定位病例中,33%的大科室、42%的中科室和40%的小科室采用甲氨蝶呤治疗。大中心与小科室在剖宫产瘢痕妊娠手术治疗中明确首选腹腔镜入路的差异有统计学意义(P = 0.036)。科室间其他参数差异无统计学意义。结论:在输卵管完整妊娠的病例中,五分之四的产科和妇科进行腹腔镜输卵管切除术,而只有五分之一的患者使用全身甲氨蝶呤进行治疗。另一方面,甲氨蝶呤是由三分之一到五分之二的各种规模的部门在非典型异位妊娠定位的情况下使用。
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来源期刊
Ceska Gynekologie-Czech Gynaecology
Ceska Gynekologie-Czech Gynaecology OBSTETRICS & GYNECOLOGY-
CiteScore
0.60
自引率
25.00%
发文量
57
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