REPEATED RECONSTRUCTION IN TUBAL PREGNANCY: INDICATIONS AND RISKS
Bibliographic record
Abstract
Objective. The goal is to assess the indications and risks for performing reconstructive operations on the fallopian tube during re-implantation of the fertilized egg in it. Material and methods. The study involved 78 patients who applied to the Department of Reconstructive Surgery of the Republican Scientific Center for Cardiovascular Surgery for repeated pregnancy in a previously operated tube in the period from 2015 to 2024. The average age of the patients was 28.6 ± 2.2 years. Of the women who applied, 65 (83.3%) were from Dushanbe, 5 (6.4%) from the Districts of Republican Subordination, 4 (5.1%) from Sughd and Khatlon regions. According to parity, the patients were divided into the following groups: women who did not have children - 32 (41.02%), women who gave birth to one child - 26 (33.3%), in 16 cases (20.5%) - 2 children, in 4 (5.1%) - three children. As can be seen from the presented data, a paradoxical situation arose: despite having undergone unsuccessful operations and having two or more children, in more than a quarter of cases women and their spouses refused radical operations. Results. Chlamydia was detected in 67 patients, and in some cases a mixed sexually transmitted infection was noted. Cytomegalovirus infection was noted in 32 patients, herpes infection in 36 women. All patients, together with their husbands, were prescribed specific antimicrobial therapy. However, in 73 cases, there were violations in taking medications either by the husband or by both spouses. As for the remote terms, repeated tubal pregnancy developed in 12 patients, in terms from 6 months to 4 years. In all cases, there was no proper treatment by a gynecologist, due to the fault of the patients. Labor with the birth of a live fetus, in terms of up to 4 years after the surgical intervention, was noted in 22 patients, which can be considered an excellent result. Conclusion. Thus, it should be noted that the main reason for the recurrence of ectopic pregnancy in the tube is the failure of patients to comply with gynecologists’ instructions in the postoperative period. Often, despite doctors’ instructions not to become pregnant for a year after the reconstruction, patients ignore these instructions. In case of repeated implantation of the ovum in the isthmic and ampullar-isthmic part, it is necessary to remove the tube, since this localization has a high risk of adhesions and repeated implantation. In other cases, the choice of radical or preserving surgery should be made based on each individual case.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".