Fernandez H, Lelaidier C, Baton C, Bourget P, Frydman R
Department of Obstetrics and Gynaecology, Hôpital Antoine Béclère, Clamart, France.
Hum Reprod. 1991 Nov;6(10):1474-7. doi: 10.1093/oxfordjournals.humrep.a137292.
The purpose of this study was to examine hysterosalpingographic findings and reproductive performance in patients previously managed non-surgically for ectopic pregnancy. Forty-nine patients with unruptured ectopic pregnancies were treated either by expectant management (n = 16) or medically (n = 33), using transvaginal methotrexate or sulprostone injection. The treatment was successful in 35 patients (71.5%), 12 out of 16 and 23 out of 33 in the two groups respectively. For all patients, follow-up currently varies from 3 to 52 months with a median follow-up of 16.6 +/- 11.2 months and 7.3 +/- 4.3 months in the two groups respectively. Hysterosalpingography was performed in 25 out of 26 patients who desired further pregnancy. We found evidence of tubal patency on the ectopic pregnancy treated side in 23 cases (92%). In this group, no recurrent ectopic pregnancy was observed. In the expectant management group, eight out of nine patients became pregnant, and the mean time to achieve pregnancy was 16.6 +/- 11.2 months. In the medical treatment group, eight out of 17 patients became pregnant and the mean time to achieve pregnancy was 8.6 +/- 4.2 months. In this last group, seven out of nine non-pregnant patients have had only a short follow-up, 4.5 +/- 3.2 months since treatment completion. No recurrent ectopic pregnancy was observed in this successfully treated group of patients who desired further pregnancy. We conclude that the medical approach to unruptured ectopic pregnancy is associated with a high rate of tubal patency and a reproductive performance similar to conservative surgical methods.
本研究的目的是检查先前非手术治疗异位妊娠患者的子宫输卵管造影结果和生殖性能。49例未破裂异位妊娠患者接受了期待治疗（n = 16）或药物治疗（n = 33），采用经阴道甲氨蝶呤或磺前列酮注射。35例患者（71.5%）治疗成功，两组分别为16例中的12例和33例中的23例。所有患者的随访时间目前为3至52个月，两组的中位随访时间分别为16.6±11.2个月和7.3±4.3个月。26例希望再次怀孕的患者中有25例进行了子宫输卵管造影。我们发现23例（92%）异位妊娠治疗侧输卵管通畅。在该组中，未观察到复发性异位妊娠。在期待治疗组中，9例患者中有8例怀孕，平均怀孕时间为16.6±11.2个月。在药物治疗组中，17例患者中有8例怀孕，平均怀孕时间为8.6±4.2个月。在最后一组中，9例未怀孕患者中有7例自治疗结束后随访时间较短，为4.5±3.2个月。在这组成功治疗且希望再次怀孕的患者中，未观察到复发性异位妊娠。我们得出结论，未破裂异位妊娠的药物治疗方法与输卵管通畅率高和生殖性能类似于保守手术方法相关。
