M Nadi1, C Richard2, L Filipuzzi3, L Bergogne3, S Douvier3, P Sagot4. 1. Service de gynécologie-obstétrique, centre hospitalier de Mâcon, 350, boulevard Louis-Escande, 71000 Mâcon, France. 2. Service de gynécologie-obstétrique, médecine fœtale et reproduction humaine, CHU de Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France. Electronic address: carolerichard7@gmail.com. 3. Service de chirurgie gynécologique et oncologique, CHU de Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France. 4. Service de gynécologie-obstétrique, médecine fœtale et reproduction humaine, CHU de Dijon, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France.
Abstract
OBJECTIVE: Interstitial, angular and corneal pregnancies are not very frequent and often mistaken, each with its own definition and prognosis. The objective of this work is to relate 10 years experience of ectopic pregnancies at the UH in Dijon, based on the latest data from the literature in term of diagnosis, management and subsequent fertility. METHOD: This is a retrospective study carried out at the UH of Dijon from 01/01/2005 to 01/01/2015. From the medical records of each patient who presented a corneal, interstitial or angular pregnancy, we identified the risk factors for ectopic pregnancy (EG), the diagnostic and therapeutic means used, and the subsequent obstetrical events. RESULTS: In 10 years, 532 EG were managed including 10 interstitials, one angular and nine cornual. The main risk factors were previous EG (50%), salpingectomy (55%), curettage (45%) and smoking (40%). The localization of the EG was done in 75% by the endo-vaginal sonography, in 25% in peroperative. Thirty-five percent were treated with methotrexate, 20% had surgery and 40% had both. Seventy-five percent of patients had at least one ulterior pregnancy. In the case of caesarean section, no dehiscence of the corneal scar was identified. CONCLUSION: This study shows the presence of medical antecedents which are risk factors of the tubular EG. A methotrexate protocol should be proposed first. Even after corneal surgery, vaginal delivery may remain possible.
OBJECTIVE: Interstitial, angular and corneal pregnancies are not very frequent and often mistaken, each with its own definition and prognosis. The objective of this work is to relate 10 years experience of ectopic pregnancies at the UH in Dijon, based on the latest data from the literature in term of diagnosis, management and subsequent fertility. METHOD: This is a retrospective study carried out at the UH of Dijon from 01/01/2005 to 01/01/2015. From the medical records of each patient who presented a corneal, interstitial or angular pregnancy, we identified the risk factors for ectopic pregnancy (EG), the diagnostic and therapeutic means used, and the subsequent obstetrical events. RESULTS: In 10 years, 532 EG were managed including 10 interstitials, one angular and nine cornual. The main risk factors were previous EG (50%), salpingectomy (55%), curettage (45%) and smoking (40%). The localization of the EG was done in 75% by the endo-vaginal sonography, in 25% in peroperative. Thirty-five percent were treated with methotrexate, 20% had surgery and 40% had both. Seventy-five percent of patients had at least one ulterior pregnancy. In the case of caesarean section, no dehiscence of the corneal scar was identified. CONCLUSION: This study shows the presence of medical antecedents which are risk factors of the tubular EG. A methotrexate protocol should be proposed first. Even after corneal surgery, vaginal delivery may remain possible.