الفهرس 
OVERVIEW OF ECTOPIC PREGNANCYOnly 14 pages are availabe for public view
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Abstract
Background: Ectopic pregnancy (EP), defined as the implantation of a fertilized ovum outside of the endometrial cavity, accounts for approximately 1 – 2 percent of all pregnancies. The incidence of EP cases has been increasing dramatically these days as a result of improved methods of diagnosis. The increase in certain risk factors also can be attributed to the rise of ectopic pregnancies. Studies suggest that the risk of recurrence in those who have had a previous ectopic pregnancy reaches 10–27%. Patients with recurrent ectopic pregnancy may actually present in a slightly different manner than a primary ectopic pregnancy. This study was conducted to provide an updated assessment on clinical presentation as well as management options for recurrent tubal ectopic pregnancy (REP) in Ain Shams University Maternity Hospital.
Methods: The current retrospective study was conducted in Ain Shams University Maternity Hospital to observe data during the period between January 2016 and December 2020. During the study period 728 women were diagnosed with an ectopic pregnancy. In this group, 556 out of 728 women (76.4 percent) were diagnosed as a tubal ectopic pregnancy and women diagnosed with recurrent tubal ectopic pregnancy (REP) were 25 out of 556 (4.5 percent) were the main subjects for this study. This accounted for (3.4 percent) of all ectopic pregnancies diagnosed during the study period. We observed the characteristics and the clinical presentation of women presented with REP at the times of admission and discharge and recorded the duration of hospitalization and the treatment options they received.
Results: Twenty five women were diagnosed as REP. The mean age of the studied group was 29.48± 5.2, twenty four percent of women were primigravida and seventy six percent were multigravida. History of pervious abortions presented in twenty eight percent of women. Forty eight percent of the studied group presented with abdominal pain while four percent presented with vaginal bleeding and forty eight percent were referred from another unit. Ultrasound criteria at the time of admission included a median endometrial thickness 8.0 (IQR 6.25-14.0), a median size of ectopic mass (vertical diameter) (mm) 35.0 (IQR 25.0-40.0) and a median size of ectopic mass (horizontal diameter) (mm) 31.0 (IQR 24.0-38.0). The median serum β-hCG concentrations 3647.0 (IQR 1285.0-8134.0). Twelve percent of women received expectant management and forty four percent received medical treatment while forty four percent were surgically managed. Median duration of hospitalization (days) was 4.0 (IQR 3-7.0).
Conclusion: Women diagnosed as tubal ectopic pregnancy have 4.5 percent chance for recurrence. When recurrent tubal ectopic pregnancy happens, women should be advised to be treated either medically or surgically. These findings will be useful to women and clinicians while considering management options for REP.