2 . 2019

Extrauterine pregnancy: analysis of changes in risk factors structure, diagnostic and treatment algorhytmes as a tool for reduction of reproductive loss

Abstract

Changes in structure of extrauterine pregnancy (EP) are connected with modification of risk factors (RF), development of diagnostic possibilities, and revision of treatment approach. Diagnostic value of some RF is on discussion now. There is a noted rise of frequency of the RF which increase rate of rare forms of EP, including caesarean scar pregnancy (CSP). Advance of high resolution ultrasound facilities shifts time of EP diagnostics to early terms. That increases the use of expectant management as a treatment strategy. Estimation of reproductive function after expectant management EP needs further investigation. Revision of forms of statistical analysis is necessary to improve management of rare forms of EP as a clinical protocol.

Keywords:extrauterine pregnancy, risks factors, caesarean scar pregnancy, treatment

For citation: Makukhina T.B., Penzhoyan G.A. Extrauterine pregnancy: analysis of changes in risk factors structure, diagnostic and treatment algorhytmes as a tool for reduction of reproductive loss. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2019; 7 (2): 51-8. doi: 10.24411/2303-9698-2019-12006. (in Russian)

References

1. Barnhart K.T., Sammel M.D., Gracia C.R., Chittams J., et al. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril. 2006; 86: 36-43.

2. Kharat D., Giri P.G., Fonseca M. A study of epidemiology of ectopic pregnancies in a tertiary care hospital of Mumbai, India. Int J Re-prod Contracept Obstet Gynecol. 2017; 6 (9): 3942-3. URL: http://dx.doi.org/10.18203/2320-1770.ijrcog20174040.

3. ACOG Practice Bulletin No. 193, March 2018.

4. Sandall J., Tribe R.M., Avery L., Mola G., et al. Short-term and long-term effects of caesarean section on the health of women and children. Lancet. 2018; 392 (10 155): 1349-57. doi: 10.1016/S0140-6736(18)31930-5.

5. Clinical recommendations (protocol of treatment) "Extrauterine (ectopic) pregnancy". 2017: 36 p. (in Russian)

6. Al-Turki H.A. Trends in ectopic pregnancies in Eastern Saudi Arabia. ISRN Obstet Gynecol. 2013; 975251: 4 p. URL: http://dx.doi.org/10.1155/2013/975251.

7. Malak M., Tawfeeq T., Holzer H., Tulandi T. Risk factors for ectopic pregnancy after in vitro fertilization treatment. J Obstet Gynaecol. Can. 2011; 33 (6): 617-9.

8. Revel A., Ophir I., Koler M., Achache H., et al. Changing etiology of tubal pregnancy following IVF. Hum Reprod. 2008; 23 (6): 1372-6.

9. Park J.E., Yuk J.S., Cho I.A., Baek J.C., et al. Ectopic pregnancy incidence in the Republic of Korea in 2009-2015: a population-based cross-sectional study. Sci Rep. 2018; 8: 17308. doi: 10.1038/s41598-018-35466-5.

10. Gaskins A.J., Missmer S.A., Rich-Edwards J.W., Williams P.L., et al. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertil Steril. 2018; 110 (7): 1328-37. doi: 10.1016/j.fertnstert.2018.08.022.

11. Kamwendo F., Forslin L., Bodin L., Danielsson D. Epidemiology of ectopic pregnancy during a 28 year period and the role of pelvic inflammatory disease. Sex Transm Infect. 2000; 76 (1): 28-32.

12. Ragab А., Mesbah Y., El-Bahlol I., Fawzy M., et al. Predictors of ectopic pregnancy in nulliparous women: a case-control study. Middle East Fertil Soc J. 2016; 21 (1): 27-30. URL: https://doi.org/10.1016/j.mefs.2015.07.002.

13. Bouyer J., Coste J., Shojaei T., Pouly J.L., et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003; 157 (3): 185-94.

14. Jacob L., Kalder M., Kostev K. Risk factors for ectopic pregnancy in Germany: a retrospective study of 100,197 patients. GMS Ger Med Sci. 2017; 15: Doc19. doi: 10.3205/000260, URN: urn:nbn:de:0183-0002605.

15. San Lazaro Campillo I.S., Meaney S., O'Donoghue K., Corcoran P. Ectopic pregnancy hospitalisations: a national population-based study of rates, management and outcomes. Eur J Obstet Gynecol Reprod Biol. 2018; 231: 174-9. doi: 10.1016/j.ejogrb.2018.10.054.

16. Ticconi C., Capogna M.V., Martelli F., Borelli B., et al. Ectopic pregnancy in women with recurrent miscarriage. J Obstet Gynaecol Res. 2018; 44 (5): 852-60. doi: 10.1111/jog.13607.

17. Bakken I.J., Skjeldestad F.E. Time trends in ectopic pregnancies in a Norwegian county1970-2004 - a population-based study. Hum Reprod. 2006; 21 (12): 3132-6.

18. Trabert B., Holt V.L., Yu O., Van Den Eeden S.K., et al. Population-based ectopic pregnancy trends, 1993-2007. Am J Prev Med. 2011; 40 (5): 556-60.

19. Shobeiri F., Parsa P., Nazari M. Epidemiology of ectopic pregnancy in Hamadan province. Zahedan J Res Med Sci (ZJRMS). 2012; 14 (4): 46-9.

20. Centers for Disease Control and Prevention (CDC). Ectopic pregnancy - United States, 1990-1992. MMWR Morb Mortal Wkly Rep. 1995; 44 (3): 46-8.

21. Aziz S., Al Wafi B., Al Swadi H. Frequency of ectopic pregnancy in a medical centre, Kingdom of Saudi Arabia. J Pak Med Assoc. 2011; 61 (3): 221-4.

22. Eskandar M., Archibong E.I., Sadek A.A., Sobande A.A. Ectopic pregnancy and seasonal variation: a retrospective study from the South Western Region of Saudi Arabia. Bahrain Med Bull. 2002; 24 (2): 63-5.

23. Al-Turki H.A. Ectopic pregnancy: prevalence and risk factors in Saudi Arabian Women. Saudi Med J. 2012; 339 (8): 179-82.

24. Blotiere P.O., Weill A., Dalichampt M., Billionnet C., et al. Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: an application to antiepileptic drug use in 4.9 million pregnant women in France. Pharmacoepidemiol Drug Saf. 2018; 27 (7): 763-70. doi: 10.1002/pds.4556.

25. Belics Z., Gerecz B., Csakany M.G. Early diagnosis of ectopic pregnancy. Orv Hetil. 2014; 155 (29): 1158-66. doi: 10.1556/OH.2014.29933.

26. Mikhail E., Salemi J.L., Schickler R., Salihu H.M., et al. National rates, trends and determinants of inpatient surgical management of tubal ectopic pregnancy in the United States, 1998-2011. J Obstet Gynaecol Res. 2018; 44 (4): 730-8. doi: 10.1111/jog.13588.

27. Bailey P.E., Andualem W., Brun M., Freedman L., et al. Institutional maternal and perinatal deaths: a review of 40 low and middle income countries. BMC Pregnancy Childb. 2017; 17: 295. doi: 10.1186/s12884-017-1479-1.

28. The Ministry of Healthcare of the Russian Federation. The main results of obstetrician-gynecological service in Russian Federation in 2017. Moscow, 2018: 31 p. (in Russian)

29. The global survey adult population about tobacco consumption: short review, 2016. URL: https://static-1.rosminzdrav.ru survey GATS. (in Russian)

30. Fylstra D.L. Tubal pregnancy: a review of current diagnosis and treatment. Obstet. Gynecol Surv. 1998; 53 (5): 320-8.

31. Chandrasekhar C. Ectopic pregnancy: a pictorial review. Clin Imaging. 2008; 32 (6): 468-73.

32. Creanga A.A., Syverson C., Seed K., Callaghan W.M. Pregnancy-related mortality in the United States, 2011-2013. Obstet Gynecol. 2017; 130 (2): 366-73. doi: 10.1097/AOG.0000000000002114.

33. Mavrelos D., Nicks H., Jamil A., Hoo W., et al. Efficacy and safety of a clinical protocol for expectant management of selected women diagnosed with a tubal ectopic pregnancy. Ultrasound Obstet Gynecol. 2013; 42: 102-7. doi: 10.1002/uog.12401.

34. Ghazali H.W., Abidin N.H.Z., Muda A.M., Hamid H.A. Comparative Study on surgical outcomes between laparoscopic and open cornuotomy in Urban Tertiary Center of Malaysia. GMIT (Gynecology and Minimally Invasive Therapy). 2018; 7 (1): 22-6.

35. Svenningsen R., Staff A.C., Langebrekke A., Qvigstad E. Fertility outcome after cornual resection for interstitial pregnancies. J Minim Invasive Gynecol. 2018 Aug 31. pii: S1553-4650(18)30436-9. doi: 10.1016/j.jmig.2018.08.017.

36. Hsu J.Y., Chen L., Gumer A.R., Tergas A.I., et al. Disparities in the management of ectopic pregnancy. Am J Obstet Gynecol. 2017; 217 (1): 49.e1-10. doi: 10.1016/j.ajog.2017.03.001.

37. Makukhina T.B., Makukhina V.V. Ectopic mural pregnancy. Kuban-skiy nauchniy meditsinskiy vestnik [Kuban Scientific Medical Bulletin]. 2017; (6): 150-60. (in Russian)

38. Diagnosis and Management of Ectopic Pregnancy Green-top Guideline No. 21 RCOG/AEPU Joint Guideline/November 2016.

39. Bouyer J., Coste J., Fernandez H., Pouly J.L., et al. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod. 2002; 17: 3224-30.

40. Gonzalez N., Tulandi T. Cesarean scar pregnancy: a systematic review. J Minim Invasive Gynecol. 2017; 24 (5): 731-8. doi: 10.1016/j.jmig.2017.02.020. Epub 2017 Mar 6.

41. Timor-Tritsch I.E., Monteagudo A., Cali G., Vintzileos A., et al. Cesarean scar pregnancy is a precursor of morbidly adherent placenta. Ultrasound Obstet Gynecol. 2014; 44: 346-53.

42. Placenta Praevia and Placenta Accreta: Diagnosis and Management Green-top Guideline No. 27a RCOG/September 2018.

43. D'Antonio F., Timor-Tritsch I.E., Palacios-Jaraquemada J., Monteagudo A., et al. First-trimester detection of abnormally invasive placenta in high-risk women: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018; 51: 176-83. doi: 10.1002/uog.18840.

44. Cali G., Forlani F., Minneci G., Foti F., et al. First-trimester prediction of surgical outcome in abnormally invasive placenta using the cross-over sign. Ultrasound Obstet Gynecol. 2018; 51: 184-8. doi: 10.1002/uog.17440.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITORS

Sukhikh Gennadii Tikhonovich

Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow

Kurtser Mark Arkadievich

Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation

Radzinsky Viktor Evseevich

Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

Buy a number Subscribe