異所性妊娠における紹介ルートの違いによる重症度の比較検討

抄録

Objective: The aim of this study was to evaluate the degree of disease severity of ectopic pregnancy dependent upon whether the hospital that transferred a patient to our institution had an obstetrician.
Design: From 2009 through 2012, 130 ectopic pregnancy procedures were performed at our institution. We divided the 130 cases into two groups: obstetrician group (transfer from an obstetrician; n = 107), and other specialties (transfers from other physicians; n = 23). We compared the two groups in regard to patient background, symptoms, and preoperative degree of disease severity.
Results: Transfers from other specialists were in a significantly worse condition in regard to hemoglobin level, degree of intraperitoneal bleeding, and blood transfusions. The patients who underwent a medical examination but had no symptoms were included in the obstetrician group (58.9%), but were not included in the other specialists group. Furthermore, the doctors in the other specialists group examined many patients who showed signs of an acute abdomen, which included many differential diagnoses. These physicians often neglected to order an HCG.
Conclusions: The severity of the impact of an ectopic pregnancy can be reduced by early consultation to an obstetrician. Therefore, communication between other specialists and obstetricians as well as the dissemination of comprehensive sex education for young women is indicated.