Svenningsen Rune, Langebrekke Anton, Qvigstad Erik
Kvinneklinikken, Ullevål universitetssykehus, 0407 Oslo.
Tidsskr Nor Laegeforen. 2007 Sep 6;127(17):2242-4.
Interstitial pregnancy is a rare type of ectopic pregnancy, with a substantially increased morbidity and mortality. A pregnancy implanted in the interstitial part of the fallopian tube is often more difficult to diagnose and has multiple treatment modalities. The incidence seems to be increasing, but few gynaecological departments have guidelines regarding diagnosis and treatment. Our experience in managing this condition is presented.
Six cases diagnosed from August 2005 to September 2006 are presented.
There are numerous treatment regimens reported for this condition, both surgical and medical. Four different treatments were chosen for the six patients presented. Two patients received methotrexate and four received surgical treatment initially. Methotrexate is an option in haemodynamically stable patients where there is no sign of rupture at the implantation site, but the optimal dosing and mode of administration is unknown. Medical treatment of these patients requires a closer follow-up than that for other ectopic pregnancies. Surgery is indicated in patients who are haemodynamically unstable and in those with a possible rupture. Surgery should also be considered as initial treatment in advanced gestations and in women who are not interested in future childbearing.
间质部妊娠是一种罕见的异位妊娠类型，其发病率和死亡率显著增加。植入输卵管间质部的妊娠通常更难诊断，且有多种治疗方式。其发病率似乎在上升，但很少有妇科科室有关于诊断和治疗的指南。本文介绍了我们处理这种情况的经验。
介绍了2005年8月至2006年9月诊断出的6例病例。
针对这种情况报告了许多治疗方案，包括手术和药物治疗。对所呈现的6例患者选择了4种不同的治疗方法。2例患者接受了甲氨蝶呤治疗，4例最初接受了手术治疗。对于血流动力学稳定且植入部位无破裂迹象的患者，甲氨蝶呤是一种选择，但最佳剂量和给药方式尚不清楚。这些患者的药物治疗需要比其他异位妊娠患者更密切的随访。对于血流动力学不稳定和可能破裂的患者，应进行手术治疗。对于孕周较大且对未来生育不感兴趣的女性，也应考虑将手术作为初始治疗方法。
