1963년 1월부터 1969년 12월까지 7년간에 걸쳐 본 이화여자대학교 의과대학 산부인과에서 자궁외 임신으로 진단 입원하여 수술받은 313예에 대하여 조사한 결과 아래와 같은 결론을 얻었다. 1) 자궁의 임신의 발생빈도는 매 41분만에 한 즉 2.43%였다. 2) 호발연령층은 31-36세군이 34.8%로 제일 많았고, 경산회수 1-2회가 36.2%로 제일 많았다. 3) 자궁외 임신환자의 과거력에 있어서 소파수술이나 임신중절수술을 받은 경험이 있는 경우가 50.4%로 많았고, 다음이 개복수술을 받은 경우로 13.1%였다. 4) 임상증상으로는 하복통이 92.7%로 제일 많았고 다음이 질출혈로서 68.6%였다. 월경이 걸른 경 우는 53%였으며 4-11주 걸른 경우가 87.3%였고, ruptured type 자궁외임신은 85%였었는데 culdecentesis 양성율은 68%였다. 5) 오진한 경우는 단 5예로서 1.60%였고, Novak의 15-30%보다 훨씬 낮았다. 6) 입원에서 수술까지의 시간적관계는 80%에서 입원 2시간 이내에 수술할 수 있었고, 쇼크환자의 40%에서 30분 이내에 수술할 수 있었다. 7) 난관임신이 90%였고, 그 중 ampullar 부위가 44.4%로 제일 많았고, 8예의 cornual 부위와 2예 의 자궁경관임신이 있었다. 8) 쇼크상태로 입원한 경우는 27.8%였고, 난관이 파열된 경우는 85%였다. 9) 수술은 주로 난관절제수술을 하였고, 47.9%에서 incidental appendectomy를 하였으나, 이로 인 한 후유증은 하나도 없었다. 도착사(D.O.A.)는 1명 있었으나, 자궁외임신의 치료, 수술을 받은 환자중에서는 사망자가 없었다.

Ectopic pregnancy is rearly an urgent and dangerous one. Diagnosis of the certain cases are still remain difficult such as unruptured one, associated with pelvic inflammatory disease, chronic ectopic pregnancy or sort of one refered from other clinic after D & C done under the impression of incomplete or complete abortion. We would like to imphasize that every minor vaginal surgery or curettage should be aseptic and active prevention on the tubal infection never be ignored in order to minimize the high incidence of ectopic pregnangy. The data to be presented are based on 313 cases of ectopic pregnancy operated on at the Ewha Woman`s University Hospital, Seoul Korea for past 7 years(1963-1969). The results were obtained as follows; 1. The incidence of ectopic pregnancies were 1:41 or 2.43% of deliveries. 2. approximately one-third (34.8%) cases of ectopic gestation have occurred at middle age group ranging from 31 to 36 year of age. 36.2% of the total subject were found to be multiparous women 1 or 2 parities. 3. It is important to notice that one-half (50.4%) cases of ectopic gestation were one who had at least one episode of curettage or induced abortion. 13% cases of all subject were one with past history of laparotomy for some lesion. These factors were strongly suggestive of a casusative factors followed by relatively silent plevic infection, which an not be ignored. 4. Most frequent symptoms of ectopic pregnancy were lower abdominal pain(92.7% of the cases) and vaginal spotting (68.6%). Skipped menstruation were about one-half (53%) of the cases and it was generally (87.3%) delayed 4 to 11 weeks. the means of culdecentesis is considered a safe and useful measures, but it`s diagnostic accuracy or positive findings were slightly more than 1/2 or 68% of the cases although the most (85%) cases of ectopic pregnancy were encountered as known ruptured type. 5. Misdiagnosed case for ectopic gestation were only 5 cases (1.60%) in which considered significantly lower in comparison with some other report of 15 to 30%. 6. We believe that times required from admission to surgery were very adequate Most of the cases (80%) were operated on within 2 hours, especially patients with severe shock or 40% of over all cases with shock were undergone surgery in 30 minutes. 7. The incidence of tubal pregnancy were 90% of the total subjects. It`s most frequent site were ampullar portion (44%), then often isthmic protion (15.3%). Less common varities were 8 caes of cornual pregnancy and 2 cases of cervical pregnancy encountered. 8. Approximately one-quater (27.8%) cases of ectopic pregnancy were in critical shock state on the admission. Most cases (85%) were ruptured one on the admission except rare incidence (15%) of unruptured lucky one. 9. The treatment of choice in tubal pregnancy is removal of the affected tube except extensively ruptured angular pregnancy which should need prompt total hysterectomy and other additional surgery for concomitant lesions. We carried out incidental appendectomy on 80% cases of the ectopic gestation without any postoperative complications or any increased incidence of recurrent ectopic geatation. Fast pressure blood transfusion through multiple route is mandatory in emergancy or operating room. There was no mortality except 1 case of D. O. A..