Managment of ipsilateral interstitial pregnancy after tubal surgery: a retrospective study focusing on focal rupture

Abstract

Study Objective：To explore the high risk factors and clinical characteristics of interstitial pregnancy rupture by retrospectively studying the clinical characteristics, diagnosis, treatment and prognosis of patients with interstitial pregnancy, so as to provide a certain reference and basis for the clinical management of interstitial pregnancy. Design: A single-center, retrospective study. Setting: A university-based hospital. Patients: Patients diagnosed with interstitial pregnancy in the Women’s Hospital, Zhejiang University School of Medicine from January 2009 to May 2022 and treated in the hospital for the first time. Interventions: A retrospective statistical analysis was performed on the case data of patients with interstitial pregnancy who met the inclusion criteria and were treated in the Obstetrics and Gynecology Hospital Affiliated to Zhejiang University Medical College, and statistical software SPSS was used for data analysis. Measurement and Main Results: A total of 885 patients with interstitial pregnancy were included in the study, including 55 patients with heterotopic interstitial pregnancies. The gestational days of patients with interstitial rupture were shorter than those of intactness(p<0.01). The risk of interstitial pregnancy rupture was higher in women with a history of ipsilateral fallopian tube surgery p<0.01). In the >42day rupture group, the gestation days were shorter in those with a history of ipsilateral surgery than those without, and the difference was statistically significant(p=0.005). The interval between ipsilateral tubal surgery and this interstitial pregnancy was 12 months as the cut-off point for analysis. The shorter the interval, the higher the risk of interstitial pregnancy rupture (p=0.001). Conclusions: Patients with a history of ipsilateral tubal surgery have a higher risk of interstitial pregnancy rupture. The shorter the interval between ipsilateral tubal surgery and interstitial pregnancy, the higher the risk of rupture. For patients with intrauterine pregnancy and interstitial pregnancy, timely treatment can also obtain term live birth.