Jourdain O, Fontanges M, Schiano A, Rauch F, Gonnet J-M
Aquitaine Gynécologie, Clinique Jean-Villar, avenue Maryse-Bastié, 33520 Bordeaux-Bruges.
J Gynecol Obstet Biol Reprod (Paris). 2003 Nov;32(7 Suppl):S93-100.
To provide recommendations for management of interstitial and ovarian pregnancies.
A Medline search was conducted and discussed by a study group of experts.
Ovarian and interstitial pregnancies are rare forms of ectopic pregnancy. Diagnostic criteria and methods are described on the basis of a review of the literature. Surgery is the usual management of interstitial pregnancy. Conservative treatment has replaced hysterectomy. Laparoscopy is an attractive way to manage interstitial pregnancies but laparotomy may still be used. Cornual resection is required. Medical treatment with methotrexate is another alternative. Local MTX seems to be more efficient than systemic administration. Management of interstitial pregnancy under laparoscopic control is an attractive way if feasible. Strong recommendations cannot be established due to the small number of reported cases reports. The pre therapeutic score cannot be used as doses are still not clear for interstitial pregnancies. For ovarian pregnancy, management is often surgical. Laparoscopy is more and more used for small gestational sacs. Methotrexate has also been used for ovarian pregnancies. Laparoscopic treatment associated with systemic MTX seems to be the more efficient way.
Because of limited data it is very hard to establish recommendations from low power studies (NP 5).
为间质部妊娠和卵巢妊娠的管理提供建议。
进行了Medline检索，并由一个专家研究小组进行讨论。
卵巢妊娠和间质部妊娠是异位妊娠的罕见形式。在回顾文献的基础上描述了诊断标准和方法。手术是间质部妊娠的常用治疗方法。保守治疗已取代子宫切除术。腹腔镜检查是处理间质部妊娠的一种有吸引力的方法，但剖腹手术仍可使用。需要进行宫角切除术。甲氨蝶呤药物治疗是另一种选择。局部甲氨蝶呤似乎比全身给药更有效。如果可行，在腹腔镜控制下处理间质部妊娠是一种有吸引力的方法。由于报告的病例数量较少，无法给出强有力的建议。由于间质部妊娠的剂量仍不明确，治疗前评分不能使用。对于卵巢妊娠，治疗通常是手术治疗。腹腔镜检查越来越多地用于处理小孕囊。甲氨蝶呤也已用于卵巢妊娠。腹腔镜治疗联合全身甲氨蝶呤似乎是更有效的方法。
由于数据有限，很难从低效能研究（NP 5）中得出建议。
