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{"id":7378,"date":"2015-12-24T10:55:42","date_gmt":"2015-12-24T08:55:42","guid":{"rendered":"https:\/\/www.coolkadin.com\/?p=7378"},"modified":"2015-12-26T11:19:23","modified_gmt":"2015-12-26T09:19:23","slug":"inmemis-over-ektopik-over","status":"publish","type":"post","link":"https:\/\/www.coolkadin.com\/inmemis-over-ektopik-over.html","title":{"rendered":"\u0130nmemi\u015f Over – Ektopik Over"},"content":{"rendered":"

Yumurtan\u0131n rahimde de\u011fil de d\u0131\u015f\u0131nda geli\u015fmesi durumudur. D\u0131\u015f gebelik d\u00f6llenmi\u015f yumurtan\u0131n rahim i\u00e7inde de\u011fil, rahim i\u00e7 hatt\u0131 d\u0131\u015f\u0131nda yerle\u015fmesidir ve b\u00fcy\u00fcmesidir. D\u0131\u015f gebelik ilk olarak 11. y\u00fczy\u0131lda tarif edilmi\u015ftir ve 20. y\u00fczy\u0131l\u0131n ba\u015flar\u0131nda cerrahi ve kan transf\u00fczyonlar\u0131n\u0131n geli\u015fine kadar \u00f6l\u00fcmc\u00fcl olan bir durum olmas\u0131na ra\u011fmen art\u0131k geli\u015fmi\u015f tan\u0131 ara\u00e7lar\u0131 ve cerrahi y\u00f6ntemler 1970\u2019lerden beri modern ila\u00e7 tedavileriyle geli\u015ftirilmi\u015ftir. B\u00f6ylece sadece kad\u0131n\u0131n hayat\u0131 de\u011fil, ayn\u0131 zamanda gelecekteki \u00fcreme yetene\u011fi de korunmaktad\u0131r.<\/p>\n

Di\u015f gebelik nas\u0131l olu\u015fur?
\nHer kad\u0131nda, her ay 1 tane yumurta \u00fcretilir ve fallop t\u00fcp\u00fcnde erke\u011fe ait spermle kar\u015f\u0131la\u015fmak ve fertilize olmak (d\u00f6llenme) i\u00e7in yolculu\u011fa \u00e7\u0131kar. Normal bir gebelikte d\u00f6llenmi\u015f yumurta (zigot) fallop t\u00fcp\u00fcndeki yolculu\u011funu tamamlar ve 3-5 g\u00fcn i\u00e7inde rahim i\u00e7ine ula\u015f\u0131r. Zigot b\u00fcy\u00fcmeye devam eder, g\u00fcvenli \u015fekilde rahim duvar\u0131na tutunur (implantasyon). Geli\u015fiminin ilk 2 ay\u0131nda zigot halinden embrio haline d\u00f6n\u00fc\u015f\u00fcr.<\/p>\n

D\u0131\u015f gebelikte d\u00f6llenmi\u015f yumurta bu yolculu\u011fu yapamaz, \u00e7\u00fcnk\u00fc fallop t\u00fcp\u00fc i\u00e7inde daralma veya t\u0131kan\u0131kl\u0131k s\u00f6z konusudur. Fallop t\u00fcp\u00fc zigotun b\u00fcy\u00fcmesi i\u00e7in yeterli b\u00fcy\u00fckl\u00fckte de\u011fildir. Sonunda t\u00fcp\u00fcn ince duvarlar\u0131 iyice gerilir ve patlar (r\u00fcpt\u00fcr). Sonu\u00e7 ciddi kanama ve belki de \u00f6l\u00fcmd\u00fcr. T\u00fcm d\u0131\u015f gebeliklerin %95\u2019inden fazlas\u0131 fallop t\u00fcp\u00fcnde olu\u015fmaktad\u0131r. Sadece %1.5 oran\u0131nda abdominal (kar\u0131n bo\u015flu\u011fu), %1\u2019den daha az oranda over (yumurtal\u0131k) veya servikste (rahim a\u011fz\u0131) g\u00f6r\u00fcl\u00fcr. D\u0131\u015f gebeli\u011fin yerle\u015fti\u011fi b\u00f6lgeye g\u00f6re tubal gebelik, overyan gebelik, servikal gebelik ve abdominal gebelik olarak tan\u0131mlan\u0131r.<\/p>\n

D\u0131\u015f gebelik di\u011fer ad\u0131yla ektopik gebelik yakla\u015f\u0131k 60 gebelikten 1\u2019inde g\u00f6r\u00fclmektedir.
\nD\u0131\u015f gebelikler s\u0131kl\u0131kla d\u00f6llenmi\u015f yumurtan\u0131n fallop t\u00fcp\u00fcnden rahime do\u011fru yolculu\u011funda problem oldu\u011funda g\u00f6r\u00fclmektedir. D\u0131\u015f gebelik, 35-44 ya\u015f kad\u0131nlarda daha s\u0131k g\u00f6r\u00fcl\u00fcr.
\nD\u0131\u015f gebelik sebepleri nelerdir?
\nD\u0131\u015f gebelik ge\u00e7iren %50 kad\u0131nda pelvik inflamatuar hastal\u0131k (PID) hikayesi vard\u0131r. Bu fallop t\u00fcplerinin enfeksiyonudur (salpenjit), rahim ve yumurtal\u0131klara yay\u0131labilir. Genellikle Gonore ve Clamidia enfeksiyonlar\u0131 sebep olmaktad\u0131r ve bunlar genellikle cinsel ili\u015fki ile bula\u015fmaktad\u0131r. Enfeksiyonlar fallop t\u00fcp\u00fcnde hasar veya t\u0131kan\u0131kl\u0131\u011fa sebep olmaktad\u0131r. Normalde, fallop t\u00fcp\u00fcn\u00fcn i\u00e7i silia denen k\u00fc\u00e7\u00fck t\u00fcys\u00fc h\u00fccrelerle kapl\u0131d\u0131r. Bu silialar yumurtan\u0131n overden fallop t\u00fcp\u00fcne, oradan da rahim i\u00e7ine do\u011fru kolayca ilerlemesinde \u00f6nemlidir. E\u011fer silialar, enfeksiyon nedeniyle hasarlan\u0131rsa yumurtan\u0131n transferi kesintiye u\u011frar. D\u00f6llenmi\u015f yumurta rahime ula\u015famadan fallop t\u00fcp\u00fcne yerle\u015fir, bunun sonucunda d\u0131\u015f gebelik meydana gelir.<\/p>\n

Di\u011fer d\u0131\u015f gebelik riskini artt\u0131ran durumlar:
\n\u00b7 Endometriosis. Normal rahim i\u00e7i dokusunun rahim d\u0131\u015f\u0131nda bulunmas\u0131 halidir ve bu durum fallop t\u00fcplerini bloke edebilir.
\n\u00b7 Fet\u00fcs\u00fcn Diethylsilbestrol (DES)\u2019a maruz kalmas\u0131. E\u011fer kad\u0131n hamileli\u011fi s\u0131ras\u0131nda DES (estrojen hormonunun sentetik versiyonu) ald\u0131ysa, karn\u0131ndaki k\u0131z bebe\u011fin t\u00fcplerinde anomali olabilir ve bu k\u0131z \u00e7ocu\u011fu ileride hamile kald\u0131\u011f\u0131nda t\u00fcplerindeki anormallik nedeniyle d\u0131\u015f gebelik ya\u015fayabilir.
\n\u00b7 Hormon almak: Estrojen ve progesteron hormonlar\u0131 menstruel siklusu d\u00fczenlemesinin yan\u0131s\u0131ra do\u011fum kontrol ama\u00e7l\u0131 ya da di\u011fer sebepler i\u00e7in kullan\u0131labilir. Bu hormonlar fallop t\u00fcp\u00fcn\u00fc de etkiler ve d\u00f6llenmi\u015f yumurtan\u0131n fallop t\u00fcp\u00fcnde yava\u015f hareket etmesine neden olabilir. Sadece progesteron i\u00e7erikli kontraseptif kullanan kad\u0131nlarda dahi d\u0131\u015f gebelik riski daha fazlad\u0131r. D\u0131\u015f gebelik ayn\u0131 zamanda t\u00fcp bebek i\u00e7in yumurtal\u0131klar\u0131 uyar\u0131c\u0131 hormon al\u0131m\u0131nda da g\u00f6r\u00fclebilir.
\n\u00b7 Rahim i\u00e7i ara\u00e7 (Spiral) kullanmak: Bu kontraseptif y\u00f6ntem fertilize olmu\u015f yumurtan\u0131n rahim i\u00e7ine implantasyonunu \u00f6nlemek i\u00e7in geli\u015ftirilmi\u015ftir. Ancak d\u0131\u015f gebelik geli\u015fimini \u00f6nlemez. Ayr\u0131ca e\u011fer kad\u0131n gebelikten korunmak i\u00e7in RIA kullan\u0131rken hamile kal\u0131rsa d\u00f6llenmi\u015f yumurta rahim i\u00e7inden ba\u015fka bir yerde implante olacakt\u0131r (%50) Progesteron hormonu i\u00e7eren RIA kullanan kad\u0131nlar\u0131n %15\u2019inde d\u0131\u015f gebelik g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Ancak RIA ile hamile kal\u0131nma olas\u0131l\u0131\u011f\u0131 son derece d\u00fc\u015f\u00fck oldu\u011fundan RIA ile d\u0131\u015f gebelik arasondaki ili\u015fki zay\u0131ft\u0131r.
\n\u00b7 Fallop t\u00fcp\u00fcn\u00fcn cerrahisi: Gebelikten korunmak i\u00e7in t\u00fcplerin ba\u011flanmas\u0131ndan sora gebe kalan kad\u0131nlarda d\u0131\u015f gebelik riski y\u00fcksektir (%60). Ayr\u0131ca t\u00fcplerini ba\u011flatmas\u0131n\u0131n ard\u0131ndan geri a\u00e7\u0131lmas\u0131 i\u00e7in yap\u0131lan cerrahi giri\u015fimler d\u0131\u015f gebelik riskini artt\u0131rmaktad\u0131r.
\n\u00b7 \u00d6nceki d\u0131\u015f gebelik \u00f6yk\u00fcs\u00fc (olas\u0131l\u0131k ilk d\u0131\u015f gebelikten sonra %15, ikinci d\u0131\u015f gebelikten sonra %30 artmaktad\u0131r)
\n\u00b7 Tekrarlanan k\u00fcrtaj \u00f6yk\u00fcs\u00fc
\n\u00b7 Sigara i\u00e7mek d\u0131\u015f gebelik riskini artt\u0131r. Bu risk doza ba\u011fl\u0131d\u0131r, i\u00e7ilen sigara say\u0131s\u0131 riski artt\u0131rmaktad\u0131r.
\nD\u0131\u015f gebelik belirtileri nelerdir?
\n\u00b7 Kar\u0131n a\u011fr\u0131s\u0131
\n\u00b7 Adet gecikmesi veya adet g\u00f6rmeme
\n\u00b7 Vajinal kanama veya aral\u0131kl\u0131 lekelenme
\nKad\u0131n hamile oldu\u011funun fark\u0131nda olmayabilir. R\u00fcpt\u00fcre d\u0131\u015f gebelikte ( \u015fiddetli i\u00e7 kanama ile birlikte) ve nonr\u00fcpt\u00fcre d\u0131\u015f gebelikte (hen\u00fcz patlamam\u0131\u015f) belirtiler tipiktir. Ancak bu belirtiler ba\u015fka durumlarda da (abort-d\u00fc\u015f\u00fck) olabilir.
\nD\u0131\u015f gebelikteki i\u015faretler ve belirtiler son adet tarihinden 6-8 hafta sonra g\u00f6r\u00fclmektedir. E\u011fer d\u0131\u015f gebelik fallop t\u00fcp\u00fcnde de\u011filse bu belirtiler daha ge\u00e7 g\u00f6r\u00fclebilir. Gebeli\u011fe ait di\u011fer belirtiler (\u00f6rne\u011fin bulant\u0131, memelerde hassasiyet..vb) d\u0131\u015f gebelikte de g\u00f6r\u00fclebilir. Halsizlik, ba\u015f d\u00f6nmesi ve bay\u0131lma r\u00fcpt\u00fcre olmu\u015f d\u0131\u015f gebelikteki \u015fiddetli i\u00e7 kanama ve d\u00fc\u015f\u00fck kan bas\u0131nc\u0131n\u0131 i\u015faret ediyor olabilir ve acil t\u0131bbi tedaviyi gerektirir. Ne yaz\u0131k kanayan d\u0131\u015f gebelikteki semptomlar tan\u0131namayabilir ve bu durum hastan\u0131n \u015fok tablosuna girmesine (d\u00fc\u015f\u00fck kan bas\u0131nc\u0131, zay\u0131f ve h\u0131zl\u0131 nab\u0131z ritmi, soluk cilt ve bilin\u00e7 kayb\u0131) neden olabilir ve acil tedavi gerektirir
\nD\u0131\u015f gebelikte a\u011fr\u0131 genellikle ilk semptomdur. A\u011fr\u0131 s\u0131kl\u0131kla tek tarafl\u0131d\u0131r, pelvis i\u00e7inde kar\u0131n bo\u015flu\u011funda hissedilir, omuz veya boyun a\u011fr\u0131s\u0131 bile olabilir. (r\u00fcpt\u00fcre d\u0131\u015f gebelikten s\u0131zan kan diafram alt\u0131nda birikir ve a\u011fr\u0131, omuz ve boyun a\u011fr\u0131s\u0131 gibi tarif edilebilir) A\u011fr\u0131 genellikle keskin ve b\u0131\u00e7ak saplan\u0131r tarzdad\u0131r. D\u0131\u015f gebelikte en b\u00fcy\u00fck endi\u015fe kar\u0131n bo\u015flu\u011funa i\u00e7 kanama olmas\u0131d\u0131r. Herhangi bir \u015f\u00fcpheli durumda acil tedavi plan\u0131 ba\u015flat\u0131lmal\u0131d\u0131r. Halsizlik ve ba\u015f d\u00f6nmesi hemen acil t\u0131bbi m\u00fcdehale gerektiren ciddi i\u00e7 kanamay\u0131 g\u00f6sterebilir.
\nErken belirtiler: D\u0131\u015f gebelikteki t\u00fcm hormonal de\u011fi\u015fiklikler normal bir gebelikte oldu\u011fu gibidir; Yorgunluk, mide bulant\u0131, adet gecikmesi, memelerde hassasiyet, bel a\u011fr\u0131s\u0131, pelvisin bir taraf\u0131nda hafif kramp tarz\u0131 a\u011fr\u0131 ve anormal vajinal kanama, genellikle lekelenme olmaktad\u0131r.
\nGe\u00e7 belirtiler: Fallop t\u00fcp\u00fcn\u00fcn dar alan\u0131 i\u00e7erisinde embrio \u00e7ok b\u00fcy\u00fcd\u00fc\u011f\u00fcnde, bir\u015feylerin yanl\u0131\u015f gitti\u011fine dair ilk belirti pelvis veya kar\u0131nda b\u0131\u00e7ak saplan\u0131r gibi a\u011fr\u0131 olmas\u0131d\u0131r. E\u011fer t\u00fcp r\u00fcpt\u00fcre olursa (patlarsa), kan diafram\u0131 irrite eder ve omuz a\u011fr\u0131s\u0131na neden olur. Di\u011fer uyar\u0131 i\u015faretleri ise ba\u015f d\u00f6nmesi ve bay\u0131lmad\u0131r.<\/p>\n

D\u0131\u015f gebelik nas\u0131l saptan\u0131r?
\nTe\u015fhiste ilk ad\u0131m doktor taraf\u0131ndan muayene ve de\u011ferlendirmedir. 2. Ad\u0131m ise gebelik testidir.
\nD\u0131\u015f gebelikte erken d\u00f6nemde doktor hastan\u0131n gebe oldu\u011funu, ancak embrionun rahim i\u00e7inde olmad\u0131\u011f\u0131n\u0131 saptamaktad\u0131r. Doktor pelvik de\u011ferlendirmede kar\u0131nda kitle ve a\u011fr\u0131 saptayabilir.<\/p>\n

Kanda yap\u0131lan baz\u0131 testler tan\u0131 koymaya yad\u0131mc\u0131 olur. Kanda Human chorionic gonadotropin (hCG) seviyesinin \u00f6l\u00e7\u00fcm\u00fc erken safhada en kullan\u0131\u015fl\u0131 testtir.Normal bir gebelikte gebeli\u011fin ilk 10 haftas\u0131nda HCG seviyesi her 2 g\u00fcnde bir 2 kat artar. D\u0131\u015f gebelikte ise genellikle hCG seviyesi y\u00fckselmesi \u00e7ok daha yava\u015ft\u0131r ve seviyesi normalden d\u00fc\u015f\u00fckt\u00fcr. (Bu bulgu d\u00fc\u015f\u00fckle sonlanan gebeliklerde de g\u00f6r\u00fclebilir). Kanda progesteron seviyeleri de \u00f6l\u00e7\u00fclebilir. Beklenen seviyeden d\u00fc\u015f\u00fck seviyeler gebeli\u011fin normal olmad\u0131\u011f\u0131n\u0131 saptayabilir.<\/p>\n

Ultrason de\u011ferlendirmesi gebeli\u011fin d\u0131\u015f gebelik olup olmad\u0131\u011f\u0131n\u0131 hakk\u0131nda bilgi sa\u011flar. Bir transducer vas\u0131tas\u0131yla hastan\u0131n vajinas\u0131 i\u00e7ine yerle\u015ftirilen veya kar\u0131n (abdominal) y\u00fczeyinden g\u00f6nderilen y\u00fcksek ses dalgalar\u0131 i\u00e7 organlar\u0131n\u0131 de\u011ferlendirirken ekranda bir g\u00f6r\u00fcnt\u00fc olu\u015fur. Doktor rahim i\u00e7inde bir fet\u00fcs\u00fcn geli\u015fip geli\u015fmedi\u011fini d\u00f6llenmeden en az 3-5 hafta sonra g\u00f6rmesi gerekir.<\/p>\n

Kuldosentez de tan\u0131 koymaya yard\u0131mc\u0131 olur. Bu i\u015flemde vajinan\u0131n arka tepe noktas\u0131ndan yerle\u015ftirilen i\u011fne, rahim arkas\u0131n\u0131 ve rektum \u00f6n\u00fcndeki alan\u0131 de\u011ferlendirir. Bu alan r\u00fcpt\u00fcre olmu\u015f fallop t\u00fcp\u00fcndeki kan\u0131n birikti\u011fi yerdir. \u0130\u011fne vas\u0131tas\u0131yla bu alandan kan geldi\u011finin g\u00f6r\u00fclmesi tan\u0131 koymam\u0131za yard\u0131mc\u0131 olur.<\/p>\n

Laparaskopi vas\u0131tas\u0131yla doktor hastan\u0131n pelvis i\u00e7inde yer alan \u00fcreme organlar\u0131n\u0131 de\u011ferlendirebilir ve d\u0131\u015f gebeli\u011fi tespit edebilir. Bu teknikte, ucunda \u0131\u015f\u0131k ve kamera olan ince bir t\u00fcp kar\u0131na yap\u0131lan k\u00fc\u00e7\u00fck bir kesiyle kar\u0131n i\u00e7ine do\u011fru g\u00f6nderilir. Bu alet kar\u0131n i\u00e7indeki organlar\u0131 g\u00f6rerek de\u011ferlendirmeye yard\u0131mc\u0131 olur.<\/p>\n

Tespit edilen d\u0131\u015f gebelikte tedavi se\u00e7enekleri nelerdir?<\/p>\n

D\u0131\u015f gebelik acil tedavi gerektirir. Erken tedavi, gelecekteki gebelikler i\u00e7in t\u00fcp\u00fcn korunmas\u0131n\u0131 sa\u011flayan en b\u00fcy\u00fck \u015fanst\u0131r.<\/p>\n

\u0130la\u00e7 Tedavisi
\nE\u011fer d\u0131\u015f gebelik \u00e7ok erken safhada ke\u015ffedildiyse Metotrexate adl\u0131 ila\u00e7 verilebilir. En iyi sonu\u00e7 i\u00e7in gebelik 6 haftadan k\u00fc\u00e7\u00fck olmal\u0131d\u0131r ve tubal kitle \u00e7ap\u0131 3.5 cm\u2019i ge\u00e7memelidir.Metotrexate tedavisinde beta-subunit (HCG) seviyesi 5000 mIU\/mL den d\u00fc\u015f\u00fck olmal\u0131d\u0131r. D\u0131\u015f gebelik tedavisinde %90 etkili olmaktad\u0131r..
\nMetotrexate tedavisi, 1987 y\u0131l\u0131ndan beri ba\u015far\u0131yla kullan\u0131lmaktad\u0131r, h\u0131zla b\u00fcy\u00fcyen zigot h\u00fccrelerinin b\u00fcy\u00fcmesini engelleme prensibiyle \u00e7al\u0131\u015f\u0131r. Bu ayn\u0131 zamanda baz\u0131 kanserlerin tedavisinde de kullan\u0131lmaktad\u0131r). \u00c7o\u011fu yan etkileri hafif ve ge\u00e7icidir, ama hastan\u0131n tedavi sonras\u0131nda izlenmesi gerekir. Genellikle ila\u00e7 tek doz halinde kas i\u00e7ine uygulan\u0131r. Ama intravenoz yolla veya direkt fallop t\u00fcp\u00fcne yerle\u015fmi\u015f embrionik doku i\u00e7ine de verilebilir. Metotrexate, ayn\u0131 zamanda erken safhalarda tespit edilmi\u015f overian, abdominal ve servikal gebelik tedavisinde de kullan\u0131labilir.
\nCerrahi Tedavi
\nLaparaskopide d\u0131\u015f gebelik saptand\u0131\u011f\u0131nda, d\u0131\u015f gebelik kitlesinin \u00e7\u0131kar\u0131lmas\u0131 i\u00e7in kar\u0131n cildine yap\u0131lan k\u00fc\u00e7\u00fck bir kesiyle baz\u0131 cerrahi aletler bat\u0131n i\u00e7ine yerle\u015ftirilir. Etkilenmi\u015f fallop t\u00fcp\u00fc onar\u0131labilir veya gerekirse \u00e7\u0131kar\u0131labilir. \u00c7o\u011fu hasta ve doktor laparaskopi y\u00f6ntemini tercih eder, \u00e7\u00fcnk\u00fc k\u00fc\u00e7\u00fck insizyon (kesi) daha h\u0131zl\u0131 toparlanmaya yard\u0131mc\u0131 olur. Ancak baz\u0131 ciddi durumlarda laparaskopi yeterli de\u011fildir veya uygun de\u011fildir. Kar\u0131n i\u00e7indeki ciddi yap\u0131\u015f\u0131kl\u0131klarda veya a\u011f\u0131r kan kayb\u0131nda laparaskopi yap\u0131lmaz. Fallop t\u00fcp\u00fcndeki hasar veya gebeli\u011fin bulundu\u011fu lokalizasyon laparatomi yap\u0131lmas\u0131n\u0131 gerektirebilir.<\/p>\n

E\u011fer gebelik r\u00fcpt\u00fcre olduysa, laparaskopi veya laparatomi (bikini \u00e7izgisi dedi\u011fimiz b\u00f6lgeden enine bir kesi) yap\u0131l\u0131r, acil olarak kan kayb\u0131n\u0131n durdurulmas\u0131 ve embrionun \u00e7\u0131kar\u0131lmas\u0131 planlan\u0131r. Her t\u00fcrl\u00fc \u00e7aba etkilenmi\u015f fallop t\u00fcp\u00fcn\u00fc korumak ve tamir etmek i\u00e7indir Ancak, e\u011fer fallop t\u00fcp\u00fc patlad\u0131ysa onarmak son derece g\u00fc\u00e7t\u00fcr, bu nedenle genellikle \u00e7\u0131kar\u0131lmas\u0131 tercih edilir.
\nPrognoz
\nD\u0131\u015f gebelikler Amerika\u2019da t\u00fcm gebeli\u011fe ba\u011fl\u0131 \u00f6l\u00fcmlerin %9\u2019unu olu\u015fturmaktad\u0131r ve ilk trimestrde (ilk 3 ay) \u00f6l\u00fcme sebep olmaktad\u0131r. D\u0131\u015f gebeliklerin %1\u2019inden fazlas\u0131 \u00f6l\u00fcmle sonu\u00e7lanabilir. D\u0131\u015f gebelik erken saptan\u0131rsa ve tedavi edilirse, sonu\u00e7 \u00e7ok iyidir. Sa\u011fl\u0131kl\u0131 bir gebelik \u015fans\u0131 d\u0131\u015f gebelik sonras\u0131 d\u00fc\u015f\u00fckt\u00fcr, ancak bu fallop t\u00fcp\u00fcndeki kal\u0131c\u0131 hasar derecesine ba\u011fl\u0131d\u0131r. E\u011fer t\u00fcp b\u0131rak\u0131l\u0131rsa, \u015fans %60 dan fazlad\u0131r. E\u011fer t\u00fcplerden biri \u00e7\u0131kar\u0131ld\u0131ysa, yumurta di\u011fer t\u00fcp i\u00e7inde d\u00f6llenecektir, ba\u015far\u0131l\u0131 bir gebelik \u015fans\u0131 %40 t\u0131r.
\nD\u0131\u015f gebelik nas\u0131l \u00f6nlenir?
\nD\u0131\u015f gebeli\u011fin pek \u00e7ok formu vard\u0131r ve \u00f6nlenemez. Ancak, d\u0131\u015f gebeliklerin b\u00fcy\u00fck \u00e7o\u011funlu\u011funu olu\u015fturan tubal gebelikler fallop t\u00fcplerinde hasar yaratan durumlardan ka\u00e7\u0131n\u0131larak \u00f6nlenebilir. T\u00fcm d\u0131\u015f gebelik ge\u00e7irmi\u015f kad\u0131nlar\u0131n yar\u0131s\u0131n\u0131n ge\u00e7mi\u015finde PID hikayesi oldu\u011fundan, cinsel yolla ge\u00e7en hastal\u0131klardan korunmak, erken te\u015fhis ve tedavi bu riski azalt\u0131r.<\/p>\n

\u00c7ok nadir de olsa, d\u0131\u015f gebelik ayn\u0131 anda i\u00e7 gebelikle beraber g\u00f6r\u00fclebilir. Bu duruma \u201cheterotopik gebelik\u201d diyoruz. Heterotopik gebelik s\u0131kl\u0131\u011f\u0131 son y\u0131llarda IVF (invitro fetilizasyon) ve di\u011fer yard\u0131mc\u0131 \u00fcreme tekni\u011fi (ART) y\u00f6ntemleri nedeniyle artm\u0131\u015ft\u0131r.
\nMolar gebelik ektopik gebelikten farkl\u0131d\u0131r. Molar gebelik, genellikle anormal genetik bilgiyle kodlanm\u0131\u015f yumurtadan geli\u015fen \u00fcz\u00fcm \u015feklinde kitlenin rahim i\u00e7inde b\u00fcy\u00fcmesidir.<\/p>\n","protected":false},"excerpt":{"rendered":"

Yumurtan\u0131n…<\/p>\n","protected":false},"author":1,"featured_media":7384,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[129],"tags":[549,169,1373,4629,225,471,4712,404],"_links":{"self":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/posts\/7378"}],"collection":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/comments?post=7378"}],"version-history":[{"count":0,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/posts\/7378\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/media\/7384"}],"wp:attachment":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/media?parent=7378"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/categories?post=7378"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/tags?post=7378"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}