Management della gravidanza extrauterina: studio retrospettivo su 87 casi consecutivi

Introduction Ectopic pregnancies represent an obstetrics emergency, but remarkable difficulties are encountered in diagnosing them. Though its characterization is crucial to define the proper management, whether surgical, medical (with Methotrexate) or expectant. Methods This study contains a retrospective analysis of patients, diagnosed with ectopic pregnancy, in the Department of Obstetrics and Gynecology of the Parma University Hospital between 2005 and 2007. A total of 87 patients were enrolled in the study. For every patients data concerning general characteristics, β-hCG levels, clinical and ultrasonographic features and expecially on the treatment performed were collected. We divided our patients into six groups according with the therapeutic management adopted with the aim of identifying available parameter to be used for therapeutic counseling in patients with diagnosis of ectopic pregnancy. Results Previous abdominal surgical interventions or ectopic pregnancies are confirmed to be important risk factors. In most cases, surgical treatment was performed, only 7 patients were succesfully treated with Methotrexate. They showed significant lower levels of β-hCG in comparison with the one of the patients treated by immediate surgery. The endometrial tickness in patients treated by medical treatment was not significant different from the one of surgical-treated patients. The incidence of adnexial mass or free fluid in the pouch of Douglas was similar in the different groups. Conclusion Patients with β-hCG levels <600mUI/ml show 7 points lower risk to undergo surgical interventions. As reported in literature medical treatment should be proposed if β-hCG levels are below 3000mUI/ml.