Læknablaðið

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Læknablaðið - 15.12.1999, Page 11

Læknablaðið - 15.12.1999, Page 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

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