Giambanco V, Giambanco L, Alaimo D
II Divisione di Ginecologia ed Ostetricia, Ospedale Civico e Benefratelli, ARNAS, Palermo.
Minerva Ginecol. 1999 Jan-Feb;51(1-2):19-25.
In pregnancies, the incidence of ectopic pregnancy varies from 1.2% to 1.4%. Diagnostic management of ectopic pregnancy is made by biochemical and ultrasonographic analysis. The evaluation of symptoms and anamnesis improves both comprehension and evaluation of technical data. This review analyzed the risk factors most commonly reported in women with ectopic pregnancy. According to the literature, the improvement of biochemical knowledge has determined the study of many substances: beta hCG, specific glycoproteins beta 1, creatine kinase, renine, progesterone. Transvaginal ultrasound examination presents different specificity and sensitivity. When ultrasonic imagining is not clear, it is useful to study uterine and adnexal vascularization by color Doppler and pulsed Doppler. The majority of authors consider laparoscopy as a gold standard for diagnosing an ectopic pregnancy. The endoscopic approach has multiple advantages: it could be in the same time diagnostic and therapeutic. The curettage of uterine cavity has been proposed as a diagnostic tool for analyzing by frozen section the presence or not of chorial villi. In personal opinion, an easy and simple diagnostic management should involve the clinical, biochemical and ultrasonographic procedures. Laparoscopy should be the last step in order to confirm a diagnosis and to establish the best therapeutical approach.
在妊娠中，异位妊娠的发生率在1.2%至1.4%之间。异位妊娠的诊断管理通过生化和超声分析进行。对症状和既往史的评估有助于提高对技术数据的理解和评估。本综述分析了异位妊娠女性中最常报道的危险因素。根据文献，生化知识的进步促使人们对多种物质进行了研究：β - 人绒毛膜促性腺激素、特异性糖蛋白β1、肌酸激酶、肾素、孕酮。经阴道超声检查具有不同的特异性和敏感性。当超声成像不清晰时，通过彩色多普勒和脉冲多普勒研究子宫和附件的血管化情况很有用。大多数作者认为腹腔镜检查是诊断异位妊娠的金标准。内镜方法有多个优点：它可以同时进行诊断和治疗。有人提出刮取宫腔组织作为一种诊断工具，通过冷冻切片分析有无绒毛膜绒毛。在我个人看来，一种简单易行的诊断管理应包括临床、生化和超声检查程序。腹腔镜检查应作为最后一步，以确认诊断并确定最佳治疗方法。
