Author/Editor		Virant, Irma; Tomaževič, Tomaž
Title		Salpingoskopija - diagnostična metoda za ugotavljanje patoloških sprememb v jajcevodu
Translated title		Salpingoscopy - a useful tool in the diagnosis of pathological changes in the tube
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 2
Publication year		2003
Volume		str. II-109-12
Language		slo
Abstract		Background. To confirm the hypothesis that the incidence of pathological changes of the mucosa in the contralateral tube is higher in women with tubal pregnancy than in fertile women. To evaluate a new method for direct assessment of the tubal mucosa, salpingoscopy. Patients and methods. In the prospective study we enrolled 58 women in the period June 1998 - April 2002. The study group consisted of 23 women with tubal pregnancy and 19 infertile women seeking diagnostic laparoscopy. The exclusion criteria was tubal pregnancy that occurred in spite of an inserted intrauterine device or after an in vitro fertilization embryo transfer (IVF-ET). The control group consisted of 16 fertile women. Laparoscopy was performed in all the enrolled women. Peritubal adhesions were diagnosed laparoscopically, whereas intratubal adhesions were diagnosed by salpingoscopic examination of the ampullary tubal mucosa. Results. Laparoscopy revealed peritubal adhesions in 37 women: in 43% of women with a history of ectopic pregnancy, in 94% of infertile women, and in 19% of fertile women. On salpingoscopy pathologic changes of the ampullary tubal mucosa were most frequent in infertile women (47.7%) less frequent in women with a history of ectopic pregnancy (26.1%), and the least frequent in fertile women (63%). Pearson correlation coefficient yielded a weak correlation between the extensiveness of laparoscopically assessed lesions and salpingoscopically assessed pathology. None of the 23 women with pathologic changes of the ampullary tubal mucosa conceived spontaneously, whereas 43.5% of women with healthy tubal mucosa on salpingoscopy conceived spontaneously. The women with diagnosed pathologic changes of the tubal mucosa were referred forI IVF treatment to prevent further ectopic pregnancies. (Abstract truncated at 2000 characters)
Summary		Izhodišča. Potrditi hipotezo, da imajo ženske z zunajmaternično nosečnostjo pogosteje patološko spremenjeno sluznico ampularnega dela kontralateralnega jajcevoda kot plodne ženske. Uvesti salpingoskopijo in oceniti njeno klinično uporabnost pri zdravljenju tubarne neplodnosti. Bolnice in postopki. V prospektivno raziskavo smo v odbobju junij 1998 in april 2001 vključili 58 žensk. V preiskovano skupino smo vključili 23 žensk z zunajmaternično nosečnostjo in 19 neplodnih žensk. Izključitvena merila so bila: zanositev v jajcevodu pri uporabi materničnega vložka ali oralne hormonske kontracepcije ter zanositev v jajcevodu po postopku zunajtelesne oploditve in prenosa zarodka (IVF-ET). V kontrolno skupino smo vključili 16 plodnih žensk, ki niso nikoli zanosile zunaj maternice in so prišle na želeno laparoskopsko sterilizacijo. Ženskam smo po predoperativni pripravi naredili laparoskopsko operacijo. Peritubarne zarastline smo diagnosticirali laparoskopsko, zarastline v jajcevodih pa s salpingoskopskim pregledom sluznice ampularnega dela jajcevodov. Rezultati. Laparoskopsko smo našli peritubarne zarastline pri 31 ženskah, od tega pri 43% žensk z anamnezo zunajmaternične nosečnosti, 94% neplodnih žensk in samo pri 19% plodnih žensk. S salpingoskopijo smo ugotovili patološko spremenjeno sluznico ampudarnega dela jajcevoda najpogosteje pri neplodnih ženskah (47,7%), manj pri ženskah z anamnezo zunajmaternične nosečnosti (26,1%) in le pri 6,3% plodnih žensk. S pomočjo korelacijskega koeficienta po Pearsonu smo ugotovili, da je obsežnost laparoskopsko ugotovljenih zarastlin slabo povezana s salpingoskopsko ugotovljeno patologijo. Od 13 žensk s patološko spremenjeno sluznico ampularnega dela jajcevoda nobena ženska ni zanosila spontano, pri ženskah s salpingoskopsko zdravo sluznico pa jih je spontano zanosilo 43,5%. (Izvleček skrajšan na 2000 znakov).
Descriptors		HYSTEROSALPINGOGRAPHY PREGNANCY, ECTOPIC INFERTILITY, FEMALE PREGNANCY, TUBAL FERTILIZATION IN VITRO