Young P L, Saftlas A F, Atrash H K, Lawson H W, Petrey F F
Division of Reproductive Health, Centers for Disease Control, Altanta, Georgia.
Obstet Gynecol. 1991 Nov;78(5 Pt 1):749-52.
Tubal pregnancy leads to reduced childbearing potential and is a major cause of maternal morbidity and mortality in the United States. Several hospital-based studies have shown a trend toward more conservative management of tubal pregnancies, which reflects attempts to reduce morbidity and preserve fertility; however, the impact on future fertility remains unclear. To study national trends in the management of tubal pregnancy from 1970-1987, we analyzed data from the National Hospital Discharge Survey. Tubal pregnancies managed conservatively, using operative procedures that attempt to preserve the function of the involved fallopian tube, increased from approximately 2% in 1970-1978 to 12% in 1984-1987. During 1979-1987, conservative procedures were more than twice as common for women with private insurance as for those without it. The use of diagnostic laparoscopy increased from 10% of tubal pregnancies in 1970-1978 to 33% in 1979-1987, whereas the use of diagnostic laparotomy decreased from 24 to 2%.
输卵管妊娠会导致生育能力下降，是美国孕产妇发病和死亡的主要原因。几项基于医院的研究表明，输卵管妊娠的治疗有更加保守的趋势，这反映了减少发病率和保留生育能力的尝试；然而，对未来生育能力的影响仍不明确。为了研究1970年至1987年输卵管妊娠治疗的全国趋势，我们分析了来自全国医院出院调查的数据。采用旨在保留受累输卵管功能的手术进行保守治疗的输卵管妊娠，从1970年至1978年的约2%增加到1984年至1987年的12%。在1979年至1987年期间，有私人保险的女性采用保守手术的比例是没有私人保险女性的两倍多。诊断性腹腔镜检查的使用率从1970年至1978年输卵管妊娠的10%增加到1979年至1987年的33%，而诊断性剖腹手术的使用率从24%降至2%。
