Data from: Risk factors and clinical features of ovarian pregnancy: a case-control study

Objective: To identify risk factors for ovarian pregnancy (OP) and compare clinical features between OP and tubal pregnancy (TP) patients. Design: Case–control study. Setting: University hospital. Participants: A case–control study was conducted from January 2005 to May 2014. Women diagnosed with OP were recruited as the case group (n=71), 145 women with TP and 146 with intrauterine pregnancy (IUP) were matched as controls at a ratio of 1:2:2. Women who refused interviews or provided incomplete information were excluded. Results: OP risk was lower than TP risk in women with serological evidence of Chlamydia trachomatis infection (adjusted OR1 0.17, 95% CI 0.06 to 0.52), previous adnexal surgery (adjusted OR1 0.25, 95% CI 0.07 to 0.95), and current levonorgestrel emergency contraceptive use (adjusted OR1 0.24, 95% CI 0.07 to 0.78). In vitro fertilisation-embryo transfer (IVF-ET) carried a higher risk of OP (adjusted OR1 12.18, 95% CI 2.23 to 66.58) than natural conception. When Controlled by IUP women, current users of intrauterine devices (IUDs) carried a higher risk of OP than non-users of any contraceptives (adjusted OR2 9.60, 95% CI 1.76 to 42.20). β-Human chorionic gonadotropin (hCG) levels on the day of surgery were higher in OP patients than in TP patients (p<0.01). Women with OP were less likely to initially present with vaginal bleeding than those with TP (p=0.02). Moreover, shock (p=0.02), rupture (p<0.01), haemoperitoneum (p<0.01) and emergency laparotomy (p<0.01) were more common in the OP group than in the TP group. Conclusions: IVF-ET and IUD use may be risk factors for OP, and OP patients tend to have high β-hCG levels and a poor clinical outcome (shock, rupture, haemoperitoneum and need for emergency laparotomy). Our findings may contribute to the prevention and early diagnosis of OP.研究目的：明确卵巢妊娠（ovarian pregnancy, OP）的危险因素，并对比卵巢妊娠与输卵管妊娠（tubal pregnancy, TP）患者的临床特征。 研究设计：病例对照研究。 研究地点：大学附属医院。 研究对象：本研究为2005年1月至2014年5月开展的病例对照研究。以确诊为卵巢妊娠的女性作为病例组（n=71），按1:2:2的比例匹配145例输卵管妊娠患者与146例宫内妊娠（intrauterine pregnancy, IUP）患者作为对照组。排除拒绝接受访谈或提供信息不完整的女性受试者。 研究结果：血清学检测提示沙眼衣原体（Chlamydia trachomatis）感染的女性，其卵巢妊娠风险较输卵管妊娠更低（校正比值比₁=0.17，95%置信区间0.06~0.52）；既往有附件手术史者（校正比值比₁=0.25，95%置信区间0.07~0.95）以及当前使用左炔诺孕酮（levonorgestrel）紧急避孕药者（校正比值比₁=0.24，95%置信区间0.07~0.78）亦呈现相同趋势。与自然受孕者相比，体外受精-胚胎移植（in vitro fertilisation-embryo transfer, IVF-ET）者发生卵巢妊娠的风险显著升高（校正比值比₁=12.18，95%置信区间2.23~66.58）。以宫内妊娠女性为对照时，当前使用宫内节育器（intrauterine device, IUD）的女性相较于未使用任何避孕措施者，卵巢妊娠风险更高（校正比值比₂=9.60，95%置信区间1.76~42.20）。卵巢妊娠患者手术当日的血清β-人绒毛膜促性腺激素（β-human chorionic gonadotropin, β-hCG）水平高于输卵管妊娠患者（p<0.01）。卵巢妊娠患者初始就诊时出现阴道流血的比例低于输卵管妊娠患者（p=0.02）。此外，休克（p=0.02）、妊娠包块破裂（p<0.01）、腹腔积血（p<0.01）及急诊剖腹探查术使用率（p<0.01）在卵巢妊娠组均显著高于输卵管妊娠组。 研究结论：体外受精-胚胎移植与宫内节育器使用可能为卵巢妊娠的危险因素；卵巢妊娠患者多表现为高β-hCG水平及不良临床结局，包括休克、妊娠包块破裂、腹腔积血及需行急诊剖腹探查术。本研究结果可为卵巢妊娠的预防与早期诊断提供参考依据。