Læknablaðið - 15.12.1999, Blaðsíða 11

LÆKNABLAÐIÐ 1999; 85
949
Utanlegsþykkt á íslandi
1985-1994
Ágúst N. Jónsson, Guðmundur Steinsson, ReynirTómas Geirsson
Jónsson ÁN, Steinsson G, Geirsson RT
Ectopic pregnancy in Iceland 1985-1994
Læknablaðið 1999; 85: 949-60
Objective: Ectopic pregnancy (EP) has increased
during the last two-three decades and diagnostic tests
and treatment have changed. Two previous studies on
ectopic pregnancy have been published in Iceland. A
study was initiated to evaluate changes over a new 10
year period.
Material and methods: All cases of histologically
confírmed ectopic pregnancy during a 10 year period
1985-1994 were reviewed. Age, previous normal and
ectopic pregnancies, diagnosis by ultrasound and use
of intrauterine contraceptive device (IUCD), inferti-
lity problems, pelvic inflammatory disease, site of
implantation and operative procedures were recor-
ded. Rates were calculated against the background of
numbers of women of reproductive age (15-44) and
of pregnancies for each year and in five-year periods.
Results: There were 1267 cases of EP with a doub-
ling of the incidence (p for trend <0.001). There were
more women of fertile age and a higher pregnancy
rate in the population, but still a significant rise in
incidence and prevalence above this. The age group
25-29 years was most common in 1985-1989, but 30-
34 years in 1990-1994. EP was a first pregnancy in
12.9% of cases during 1985-1989 and 15.8% in 1990-
1994. The total number of women with a previous EP
rose between five-year periods. A repeated EP occur-
red in 16.5%, most commonly in the age 30-34 years.
There were 104 women with two EPs, 44 with three,
14 with four, two with five and one each with six,
Frá Kvennadeild Landspítalans, 101 Reykjavík. Fyrirspurn-
ir, bréfaskipti: Guðmundur Steinsson, Kvennadeild Land-
spítalans, 101 Reykjavík. Sími: 560 1000, bréfsími: 560
1191, netfang: gst@tv.is
Lykilorð: utanlegsþykkt, þungun, greining með ómskoðun,
kviðarholsspeglun.
seven and eight. Implantation was more often on the
right side (p<0.0001). In l.l% tubai sterilization had
been done. Ultrasound was increasingly used as a
diagnostic tool; for 68.4% of the women in the second
period. Women with infertility totalled 27%. In 17%
the women had an IUCD. Ovarian EP was only seen
in eight cases (0.63%) and abdominal EP in two. Sur-
gical procedures changed significantly with laparo-
scopic techniques being used increasingly.
Conclusions: The incidence of EP has increased in
Iceland until in the most recent years. Treatment has
changed and the need for longer hospitalisation de-
clined.
Key words: ectopic pregnacy, pregnancy, ultrasound
diagnosis, laparoscopy.
Ágrip
Tilgangur: Tíðni utanlegsþykkta hefur auk-
ist á síðasta aldarfjórðungi, hérlendis sem ann-
ars staðar. Tvær rannsóknir hafa áður verið
birtar um utanlegsþykkt á Islandi og ný athug-
un var gerð til að meta breytingar sem síðan
hafa orðið.
Efniviður og aðferðir: Greiningar á utan-
legsþykkt í sjúkdómsgreiningaskrám 12 helstu
sjúkrahúsa landsins voru athugaðar á 10 ára
tímabili 1985-1994 og vefjagreiningarsvar fyr-
ir hvert tilfelli kannað. Leitað var upplýsinga
um aldur, fyrri þunganir og utanlegsþykktir,
greiningu, lykkjunotkun, ófrjósemivandamál,
eggjaleiðarabólgu, aðgerðir og staðsetningu.
Algengi og nýgengi miðað við fjölda kvenna á
frjósemiskeiði og þungana fyrir hvert ár og
fimm ára aldursbil var reiknað. Línuleg til-
hneiging var reiknuð fyrir breytingu milli ára
og helstu breytur bomar saman milli fimm ára
tímabila.
Niðurstöður: Alls fundust 1267 tilfelli.
Tíðnin meira en tvöfaldaðist (p fyrir línulega