Hospital admission and surgical approach to ectopic pregnancy in Clinical hospital ‘Sveti Duh’ from 2015-2020

master's thesis

• Title (croatian): Kirurški pristup u bolesnica s ektopičnom trudnoćom hospitaliziranih u kb "Sveti Duh" u razodblju od 2015. do 2020. godine
• Author: Bruna Bušić
• Mentor: Ivanka Bekavac Vlatković (mentor)
• Committee member: Ivanka Bekavac Vlatković (predsjednik povjerenstva)
• Committee member: Alan Šerman (član povjerenstva)
• Committee member: Željko Duić (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

INTRODUCTION: Ectopic pregnancy is a term for any pregnancy where the implantation occurs outside the uterine cavity. It occurs in approximately 0.6-1.0% of all pregnancies and is most commonly localized within the fallopian tube. Main risk factors associated with ectopic pregnancy are tubal scarring, mainly due to history of infection or surgery, and smoking. Diagnosis relies on the combination of transvaginal ultrasound and measurement of serum β-hCG levels. Ectopic pregnancy may be treated with
expectant management, pharmacologic therapy, or surgery. Despite advancements in diagnosis and treatment, hemorrhage due to ectopic pregnancy remains the leading cause of maternal mortality in the first trimester. ----- GOAL: The goal of this research paper was to present length of hospital stay and surgical treatment of patients treated for ectopic pregnancy in Clinical hospital ‘Sveti duh’ 2015 to 2020. ----- METHOD: Data was collected from the hospital electronic database and books of surgical procedures and then processed in the SPSS (Statistical Package for the Social Sciences) software. ----- RESULTS: Following data collection, 139 patients surgically treated for ectopic pregnancy were included and analyzed in this study. Out of 139 patients surgically treated for ectopic pregnancy, 134 (96,4%) have undergone laparoscopic procedure, while only 5 (3,6%) had open surgery. Salpingectomy was the technique most performed (82,7%), followed by salpingotomy (8,6%). The mean hospitalization time of surgically treated patients was 1,78 days and was dependent on the type of performed procedure. ----- CONCLUSION: Since the 2015 there has been a decrease in frequency of tubal-sparing surgery as surgical approach for the treatment of ectopic pregnancy. The increase in the frequency of laparoscopic salpingectomy is evident.

Abstract (croatian)

UVOD: Ektopična trudnoća je pojam za svaku trudnoću u kojoj se implantacija događa izvan šupljine maternice. Javlja se u otprilike 0,6-1,0% svih trudnoća, a najčešće je lokalizirana unutar jajovoda. Glavni čimbenici rizika povezani s ektopičnom trudnoćom su ožiljci u jajovodu, najčešće zbog prijašnje infekcije ili kirurškog zahvata, te pušenje. Dijagnostička evaluacija pacijentica se oslanja na kombinaciju transvaginalnog ultrazvuka i mjerenja razine β-hCG-a u serumu. Ektopična trudnoća može se liječiti ekspektativnim liječenjem, farmakološkom terapijom ili kirurškim zahvatom. Unatoč napretku u dijagnozi i liječenju, krvarenje zbog ektopične trudnoće ostaje vodeći uzrok smrtnosti majki u prvom tromjesečju. ----- CILJ RADA: Cilj ovog istraživačkog rada bio je prikazati duljinu boravka u bolnici i kirurško liječenje pacijentica liječenih zbog ektopične trudnoće u Kliničkoj bolnici ‘Sveti duh’ 2015. do 2020. godine. ----- METODA: Podaci su prikupljeni iz bolničke elektroničke baze podataka i knjige kirurških zahvata, a zatim obrađeni u softveru SPSS (Statistical Package for the Social Sciences). ----- REZULTATI: Nakon prikupljanja podataka, u ovom je istraživanju analizirano 139 pacijentica kirurški liječenih zbog ektopične trudnoće. Od 139 žena, 134 (96,4%) je imalo laparoskopski zahvat, dok je samo 5 (3,6%) imalo laparotomiju. Salpingektomija je tehnika koja se najčešće izvodila (82,7%), a slijedila ju je salpingotomija (8,6%). Prosječno vrijeme hospitalizacije operativno liječenih pacijentica je bilo 1,78 dana i ovisilo je o odabranom kirurškom pristupu. ----- ZAKLJUČAK: Od 2015. godine zabilježen je pad učestalosti operacija s namjerom očuvanja oba zdrava jajovoda. Ističe se rastući trend učestalosti laparoskopske salpingektomije.

• Keywords: ectopic pregnancy; treatment; surgery; hospitalization; salpingectomy
• Keywords (croatian): ektopična trudnoća; liječenje; operacija; hospitalizacija; salpingektomija
• Language: english
• URN:NBN: urn:nbn:hr:105:319974
• Study programme: Title: Medicine (in English language); 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: 2021-12-21 08:18:26