Dijagnostika i liječenje ektopične trudnoće u KB "Sveti Duh" u razdoblju od 2009.-2019.

master's thesis

• Title (english): Diagnosis and treatment of ectopic pregnancy at the University Hospital "Sveti Duh" from 2009 to 2019
• Author: Žaklina Cvitkušić
• Mentor: Tatjana Pavelić Turudić (mentor)
• Committee member: Ivanka Bekavac Vlatković (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Tatjana Pavelić Turudić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

UVOD: Ektopična trudnoća je svaka trudnoća s implantacijom izvan fiziološkog sijela u šupljini maternice. Javlja se u 0,25-1,4% svih trudnoća i predstavlja po život opasno stanje. Najčešći je uzrok maternalnog mortaliteta u prvom tromjesečju trudnoće. Najvažnije dijagnostičke metode čine transvaginalni ultrazvuk i mjerenje serumske razine β-hCG-a. Ektopična trudnoća može se liječiti medikamentozno, kirurški ili ekspektativnim postupkom. ----- CILJ: Cilj ovog rada bio je prikazati dijagnostičke parametre, metode liječenja i trajanje hospitalizacije pacijentica kojima je dijagnosticirana ektopična trudnoća u KB „Sveti Duh“ u razdoblju od 2009. do 2019.godine te utvrditi njihovu međusobnu povezanost. ----- METODE: Retrospektivno istraživanje provedeno je prikupljanjem podataka iz bolničkog informatičkog sustava. Podaci su zatim analizirani statističkim programom SPSS. -----
REZULTATI: Analizom podataka obuhvaćeno je 268 pacijentica hospitaliziranih zbog ektopične trudnoće u KB „Sveti Duh“. Srednja dob pacijentica iznosila je 32,53 godine. Temelj dijagnostike bio je ultrazvučni nalaz kojim se u 82% slučajeva potvrdila dijagnoza te mjerenje serumske razine β-hCG-a čija je prosječna vrijednost bila 3171,40 IU/ml. Pacijentice s najvišim prosječnim vrijednostima β-hCG-a (4439,77 IU/ml) liječene su kirurški, a one s najnižim vrijednostima (547,86 IU/ml) ekspektativnim postupkom. Najčešće korištena metoda terapije bila je kirurško liječenje (63,8%), i to laparoskopskom salpingektomijom, a zatim medikamentozno liječenje metotreksatom (20,52%) te ekspektativan postupak (15,67%). Zabilježena su svega 3 slučaja rupture jajovoda (1,12%). ----- ZAKLJUČAK: Budući da je ektopična trudnoća najčešći uzrok maternalnog mortaliteta u prvom tromjesečju trudnoće te predstavlja po život opasno stanje, važno je rano postaviti dijagnozu i započeti liječenje. Sve veći broj žena koje se liječe ekspektativnim postupkom i sve manji broj ruptura jajovoda ukazuju na pozitivan trend sve ranijeg postupanja.

Abstract (english)

INTRODUCTION: Any pregnancy with implantation outside of the physiological site in the uterine cavity is called ectopic. Ectopic pregnancy presents in 0,25 – 1,4% of pregnancies and is considered to be a life-threatening condition. It is also the most common cause of maternal mortality in the first trimester. The most important methods of diagnosis are the transvaginal ultrasound and measuring the patient’s levels of β-hCG. Ectopic pregnancy can be treated with medicaments, surgically, or by expectant management. ----- OBJECTIVE: The aim of the study was to present the diagnostic parameters, treatment methods and duration of hospitalization of patients diagnosed with ectopic pregnancy at the University hospital "Sveti Duh" from 2009 to 2019 and to determine their relationship. ----- METHODS: Retrospective research has been conducted by gathering data from the hospital’s computer database. The data was then analyzed using the statistic program SPSS. ----- RESULTS: Data analysis gathered 268 patients hospitalized for ectopic at the University hospital Sveti Duh. Mean patients` age was 32,53. The most common diagnostic methods were utrasound which confirmed the diagnosis in 82% of the cases, and serial measurement of β-hCG, whose average value was 3171,40 IU/ml. Patients with the highest average levels of β-hCG (4439,77 IU/ml) were surgically treated, and those with the lowest levels (547,86 IU/ml) by expectant menagement. The most commonly used method was surgical treatment (63,8%) by laparoscopic salpingectomy, followed by medicament-based treatment using methotrexate (20,52%) and expectant management (15,67%). Only 3 cases (1,12% of fallopian tube rupture were noted. ----- CONCLUSION: Considering the fact that ectopic pregnancy is the most common cause of first trimester maternal mortality and is a life-threatening condition, early diagnosis and treatment is vital. A growing number of women being treated by expectant management and a diminishing number of fallopian tube ruptures indicate a positive trend of earlier diagnosis and treatment.

• Keywords: dijagnostika; ektopična trudnoća; liječenje; salpingektomija; ultrazvuk; β-hCG
• Keywords (english): diagnostics; ectopic pregnancy; treatment; salpingectomy; ultrasound; β-hCG
• Language: croatian
• URN:NBN: urn:nbn:hr:105:358583
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-01-28 13:23:06