1980년 1월부터 1988년 12월까지 만 9년동안 전북대학교병원 산부인과에서 난관불임술 후 발생된 자궁외임신 68예를 대상으로 임상적분석을 시행하여 다음과 같은 결론을 얻었다. 1. 총 455예의 자궁외임신중 난관불임술 후 발생된 자궁외임신의 발생빈도는 68예(14.9%)였다. 2. 연령분포는 23세부터 46세까지였고 평균연령은 33.5세였으며 30∼34세군이 44.2%로 가장 높은 빈도를 나타냈다. 3. 임신력은 평균 4.4회, 생존아 수는 평균 2.8명이었고 인공유산력은 경험이 없는예가 30.9%로 가장 많았으며 평균횟수는 1.4회였다. 4. 난관불임술 후 자궁외임신 발생까지의 기간은 6일에서 10년까지였고 평균 발생기간은 3.1년이었다. 5. 최종월경일에서 자궁외임신까지의 기간은 4+4에서 13+2주까지였고 평균기간은 7.8주였다. 6. 난관불임술 후 발생된 자궁외임신 68예중 60예(88.3%)는 복강경에 의한 것이었고 8예(11.7%)는 Pomeroy방법에 의한 것이었다. 7. 주요증상 및 소견은 전예에서 하복통을 호소하였고 72.1%에서 골반부의 중압감을 보였다. 초진시 혈색소의 평균치는 9.8g/dl였고 평균 수혈량은 3.5pints였다. 더글라스와 천자는 97.0%에서 양성으로 뇨 임신반응검사에서는 61.8%에서 양성으로 나타났다. 평균 복강내 출혈량은 약 1,400 CC였다. 8. 전에는 난관임신이었으며 팽대부가 64.7%, 협부 27.9%가 발생하였고 중절양식은 난관파열형(61.8%)이 난관유산형(38.2%)보다 많았다. 9. 수술방법은 환측 난관절제술이 47.1%, 환측부속기 절제술이 36.8%였으며 자궁적출술도 13.2%였다.

This clinical and statistical study was attempted to analyze 68 cases of ectopic pregnancies after tubal sterilization by laparoscopy and Pomeroy method at the Department of Obstetrics and Gynecology, Chonbuk National University Hospital during the period Jan. 1980 to Dec. 1988. 1. The incidence of ectopic pregnancy after tubal sterilization during the past 9 years was 14.9%. 2. The most prevalent age group was 30 to 34 years(44.2%) and the mean age was 33.5 years. 3. The mean number of gravidity was 4.4 and that of living children was 2.8. 4. The mean interval between laparoscopic tubal sterilization and the developement of ectopic pregnancy was 3.1 years. 5. The mean interval between last menstrual period and the development of ectopic pregnancy was 7.8 weeks. 6. 60 cases(88.3%) underwent laparoscopic procedure(ring: 35 cases, cauterization: 25 cases) and 8 cases(11.7%) underwent Pomeroy method(C-section: 2 cases, minilaparotomy: 6 cases). 7. Lower abdominal pain was the most common symptom(100%), with bearing down sense occurring in 72.1% of cases. The mean hemoglobin level at admission was 9.8g/dl and mean amount of transfused blood was 3.5 pints. As a result of performing culdocentesis in 66 cases, 97.0% was positive. Urine pregnancy test was positive in 61.8% of 68 cases. The mean intraperitoneal blood loss was about 1,400 cc. 8. All the patients were tubal pregnancies and the most common site was ampullar portion(64.7%). The tubal pregnancy was terminated by rupture in 61.8% and by abortion in 38.2%. 9. 47.1% of total cases were treated by salpingectomy, 36.8% by adnexectomy and 13.2% by total abdominal hysterectomy.