β-人绒毛膜促性腺激素水平最低可检测时的异位妊娠破裂：2例报告
Rupture of ectopic pregnancy with minimally detectable beta-human chorionic gonadotropin levels: a report of 2 cases.
作者信息
Fu Joyce, Henne Melinda B, Blumstein Sylvie, Lathi Ruth B
机构信息
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford University IVF Program, 900 Welch Road, Suite 350, Palo Alto, CA 94304, USA.
出版信息
J Reprod Med. 2007 Jun;52(6):541-2.
BACKGROUND
Several studies have demonstrated that 25-77% of ectopic pregnancies spontaneously resolve with expectant management. However, expectant management is controversial and should be considered only for patients with small, unruptured gestational sacs, low beta-human chorionic gonadotropin (beta-hCG) levels and absence of symptoms. There is no consensus on how long to follow such patients.
CASES
Two patients with beta-hCG levels < 10 mIU/mL presented with ruptured ectopic pregnancy and hemoperitoneum.
CONCLUSION
While expectant management of a suspected ectopic pregnancy may allow spontaneous resolution of such an ectopic pregnancy, rupture may occur at any time and even with extremely low beta-hCG levels. Patients need to be counseled about the risks of rupture and symptoms, immediate action should be taken if symptoms develop, and serum beta-hCG levels should be followed to zero.
背景
多项研究表明，25%至77%的异位妊娠可通过期待治疗自然消退。然而，期待治疗存在争议，仅适用于妊娠囊小、未破裂、β-人绒毛膜促性腺激素（β-hCG）水平低且无症状的患者。对于此类患者应随访多长时间尚无共识。
病例
两名β-hCG水平<10 mIU/mL的患者出现异位妊娠破裂和腹腔积血。
结论
虽然对疑似异位妊娠进行期待治疗可能使异位妊娠自然消退，但破裂可能在任何时候发生，甚至在β-hCG水平极低时也会发生。需要向患者告知破裂风险和症状，如果出现症状应立即采取行动，并随访血清β-hCG水平直至降至零。
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