434 articles – 313 references  [version française]
Short view
Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases.
BOUYER J., Coste J., Fernandez H., Pouly J.-L., Job-Spira N.
Hum Reprod 17 (2002) 3224-30 - http://www.hal.inserm.fr/inserm-00086495
(12456628)
Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases.
Jean BOUYER1, Joël Coste1, 2, Hervé Fernandez2, Jean-Luc Pouly3, Nadine Job-Spira1
1:  Epidémiologie, Démographie et Sciences Sociales: santé reproductive, sexualité et infection à VIH
INSERM : U569 – INED – IFR69 – Université Paris XI - Paris Sud
Secteur Bleu 82, Rue du General Leclerc 94276 LE KREMLIN BICETRE CEDEX
France
2:  Service de gynécologie-obstétrique, médecine de la reproduction [Béclère]
Assistance publique - Hôpitaux de Paris (AP-HP) – Hôpital Antoine Béclère – Université Paris XI - Paris Sud
157, rue de la Porte de Trivaux 92141 Clamart
France
3:  Service de Gynécologie Obstétrique
Hôpital Hotêl-Dieu
BP 69-63003 Clermont-Ferrand
France
BACKGROUND: Several risk factors for ectopic pregnancy (EP) have been identified, but the site of implantation of EP has been little studied. METHODS: A total of 1800 surgically treated EP was registered between January 1992 and December 2001 in the Auvergne EP register and the women concerned were followed up. In this large population-based sample, we studied the distribution of EP sites, immediate complications, determining factors, and subsequent fertility. RESULTS: EP sites were interstitial (2.4%), isthmic (12.0%), ampullary (70.0%), fimbrial (11.1%), ovarian (3.2%) or abdominal (1.3%). No cervical pregnancies were observed. Complications and treatment depended on the site of EP. In multivariate analysis, the only risk factor associated with EP site was current use of an intrauterine device (IUD), which was more frequent in distal EP. The 2 year cumulative rate of subsequent spontaneous intrauterine pregnancy (IUP) increased progressively from interstitial to ovarian EP. Fair concordance (weighted kappa = 0.31) was observed between the sites of two successive EP if they were homolateral. CONCLUSION: In addition to providing an accurate description of the sites of implantation of EP, this study shows that current IUD use 'protects' against interstitial pregnancies, which are the most difficult to manage. It shows that subsequent fertility tends to be higher in women with distal EP.
Life Sciences/Health Care Sciences and Epidemiology
Life Sciences/Human health and pathology/Obstetrics & Gynecology
English
0268-1161

Article in peer-reviewed journal
Hum Reprod
2002
17
3224-30

Adult – Embryo Implantation – Female – Humans – Infertility – Intrauterine Devices – Ovary – Pregnancy – Abdominal – Ectopic – Tubal – Recurrence – Research Support – Non-U.S. Gov't – Adult