{
    "abstract": "To evaluate the incidence, the risk factors, and the treatment outcomes of Non-tubal ectopic pregnancies (NTEP) treated in a tertiary care center.\nA total of 110 NTEP cases treated between 2014 and 2019 were included in the retrospective study. The study cohort was divided into 6 groups according to the pregnancy localization: 87 cesarean scar pregnancies (CSPs), 7 ovarian pregnancies, 6 interstitial pregnancies, 4 rudimentary horn pregnancies, 4 abdominal pregnancies, and 2 cervical pregnancies. One woman rejected all treatment modalities. Demographic characteristics, treatment modalities, and outcomes of each group were evaluated.\nIn the study cohort, expectant management was performed in one (0.9%) woman. The methotrexate (MTX) treatment was administered in 29 (26.3%) women. Seventeen (15.4%) women underwent surgery, and 63 (57.2%) women underwent manual vacuum aspiration (MVA). A woman rejected all treatment modalities. Although 70.1% (n\u2009=\u200961) of CSPs were cured with MVA, 24.1% (n\u2009=\u200921) of them were treated with a single-dose MTX regimen in addition to MVA. The higher mean gestational sac size (33,9\u2009\u00b1\u200912,96\u00a0mm vs. 17,34\u2009\u00b1\u20099,87\u00a0mm), the higher mean gestational week (8,43\u2009\u00b1\u20091,16w vs. 6,66\u2009\u00b1\u20091,49w), the presence of fetal heartbeat (FHB) (90.5% vs. 26,2%) and the history of pelvic \u0131nflammatory disease (PID) (38.1% vs. 6,6%) were found in the CSPs with MVA treatment failure (p\u2009<\u20090.05).\nThe management of NTEPs should be individualized according to the clinical and ultrasonographic findings. The size of the ectopic pregnancy mass, the gestational week, the presence of FHB, and the PID history were the predictive factors for the failure of MVA in CSP cases.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Etlik Z\u00fcbeyde Han\u0131m Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey. yildizakdasreis@hotmail.com.",
            "firstname": "Y\u0131ld\u0131z",
            "initials": "Y",
            "lastname": "Akda\u015f Reis"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Etlik Z\u00fcbeyde Han\u0131m Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.\nBing\u00f6l Maternity and Children Hospital, Bing\u00f6l, Turkey.",
            "firstname": "Arife",
            "initials": "A",
            "lastname": "Akay"
        },
        {
            "affiliation": "Department of Perinatology, Etlik City Hospital, Ankara, Turkey.",
            "firstname": "Merve",
            "initials": "M",
            "lastname": "\u00d6zkan"
        },
        {
            "affiliation": "Department of Perinatology, Etlik City Hospital, Ankara, Turkey.",
            "firstname": "Seval",
            "initials": "S",
            "lastname": "Y\u0131lmaz Ergani"
        },
        {
            "affiliation": "Department of Perinatology, Etlik City Hospital, Ankara, Turkey.",
            "firstname": "Sadullah",
            "initials": "S",
            "lastname": "\u00d6zkan"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Etlik Z\u00fcbeyde Han\u0131m Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.",
            "firstname": "Tu\u011fba",
            "initials": "T",
            "lastname": "K\u0131nay"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Bilkent City Hospital, Ankara, Turkey.",
            "firstname": "Salim",
            "initials": "S",
            "lastname": "Erkaya"
        }
    ],
    "conclusions": "The management of NTEPs should be individualized according to the clinical and ultrasonographic findings. The size of the ectopic pregnancy mass, the gestational week, the presence of FHB, and the PID history were the predictive factors for the failure of MVA in CSP cases.",
    "copyrights": "\u00a9 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",
    "doi": "10.1007/s00404-023-07338-5\n10.18203/2320-1770.ijrcog20160575\n10.1186/s40738-015-0008-z\n10.1007/s00404-012-2696-5\n10.1016/j.bpobgyn.2008.12.011\n10.1097/OGX.0000000000000832\n10.1080/14767058.2019.1670807\n10.1007/s00404-016-4069-y\n10.1016/S0015-0282(01)01795-2\n10.1016/j.ijgo.2011.07.032\n10.1111/1471-0528.14752\n10.1080/00016340701434476\n10.1093/humrep/12.3.608\n10.1016/s0899-7071(02)00587-9\n10.7863/jum.2012.31.2.319\n10.1016/j.tjog.2017.12.018\n10.1097/AOG.0000000000004423",
    "journal": "Archives of gynecology and obstetrics",
    "keywords": [
        "Cesarean Scar Pregnancy",
        "Ectopic Pregnancy",
        "Manual vacuum aspiration",
        "Methotrexate",
        "Non-Tubal",
        "Surgery"
    ],
    "methods": null,
    "publication_date": "2024-01-22",
    "pubmed_id": "38252304\n28620520\n23291925\n19230785\n33111962\n31575309\n27056054\n11384652\n32609376\n21982853\n28626980\n17712645\n26554319\n9130768\n12932688\n22298877\n29458878\n34259461",
    "results": "In the study cohort, expectant management was performed in one (0.9%) woman. The methotrexate (MTX) treatment was administered in 29 (26.3%) women. Seventeen (15.4%) women underwent surgery, and 63 (57.2%) women underwent manual vacuum aspiration (MVA). A woman rejected all treatment modalities. Although 70.1% (n\u2009=\u200961) of CSPs were cured with MVA, 24.1% (n\u2009=\u200921) of them were treated with a single-dose MTX regimen in addition to MVA. The higher mean gestational sac size (33,9\u2009\u00b1\u200912,96\u00a0mm vs. 17,34\u2009\u00b1\u20099,87\u00a0mm), the higher mean gestational week (8,43\u2009\u00b1\u20091,16w vs. 6,66\u2009\u00b1\u20091,49w), the presence of fetal heartbeat (FHB) (90.5% vs. 26,2%) and the history of pelvic \u0131nflammatory disease (PID) (38.1% vs. 6,6%) were found in the CSPs with MVA treatment failure (p\u2009<\u20090.05).",
    "title": "Non-tubal ectopic pregnancy treatment experiences of a tertiary care center.",
    "xml": "<Element 'PubmedArticle' at 0x788504d69cb0>"
}