Acute and chronic presentation of ectopic pregnancy may be two clinical entities
| Autor: | Amy Hummel, Mary D. Sammel, Jesse Chittams, Joseph E. Pena, Paolo Rinaudo, Kurt T. Barnhart |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
medicine.medical_specialty media_common.quotation_subject Fertility Disease Dilatation and Curettage Pregnancy Risk Factors Internal medicine Medicine Humans Chorionic Gonadotropin beta Subunit Human media_common Retrospective Studies Blood type Ectopic pregnancy business.industry Age Factors Obstetrics and Gynecology Retrospective cohort study Odds ratio medicine.disease Confidence interval Surgery Pregnancy Ectopic Reproductive Medicine Acute Disease Chronic Disease Female Presentation (obstetrics) business Biomarkers |
| Zdroj: | Fertility and sterility. 80(6) |
| ISSN: | 0015-0282 |
| Popis: | Objective The diagnosis of ectopic pregnancy (EP) is often confirmed at presentation (acute), but often requires serial β-hCG levels to confirm the diagnosis (chronic). The purpose of this study is to analyze whether these clinical presentations represent a spectrum of disease. Design The retrospective cohort study of 452 patients diagnosed with EP at the University of Pennsylvania in the years 1990–1999. Setting University of Pennsylvania, Philadelphia, Pennsylvania. Patient(s) Four hundred fifty-two patients diagnosed with EP. Patients diagnosed with EP were divided into two groups according to the time of diagnosis. Main outcome measure(s) A total of 37 parameters were examined including historic and demographic factors, findings at presentation, and treatment and outcome variables. Result(s) The two groups were similar in terms of historic EP risk factors. Multivariable analysis demonstrates that women with a chronic presentation were less likely to have received fertility medications (odds ratio [OR] 0.23; 95% confidence interval [CI] 0.06–0.84), less likely to present with pain (OR 0.29; 95% CI 0.12–0.71), have a lower β-hCG level at presentation (9,849 mIU/mL ± 16,726 vs. 1,787 mIU/mL ± 4,717), lower chance of rupture (OR 0.19; 95% CI 0.05–0.73), and less frequently have blood type 0. Conclusion(s) Women diagnosed with ectopic pregnancy can be categorized into two groups, those with an acute presentation and those with a chronic presentation. Differences in risk factors, presentation, and outcome may reflect differences in trophoblast viability or invasive potential. |
| Databáze: | OpenAIRE |
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