Dumesic D A, Hafez G R
Department of Obstetrics and Gynecology, University of Wisconsin Medical School, Madison.
Obstet Gynecol. 1991 Nov;78(5 Pt 2):960-2.
This report describes the first known case of delayed hemorrhage of a persistent ectopic pregnancy following surgical and medical therapy. A 2.5-cm ampullary pregnancy without cardiac activity was removed by laparoscopic salpingostomy. The serum beta-hCG level before laparoscopy was 1542 mIU/mL, increasing to 3163 mIU/mL by the eighth postoperative day. Administration of methotrexate and citrovorum factor caused a 48% decline in the level of serum beta-hCG over 72 hours, but did not prevent delayed hemorrhage by the tubal gestation. This case emphasizes that close surveillance during the treatment of persistent ectopic pregnancy should continue until serum beta-hCG is undetectable.
本报告描述了首例已知的经手术和药物治疗后持续性异位妊娠延迟出血的病例。通过腹腔镜输卵管造口术切除了一个2.5厘米的壶腹部妊娠囊，无心跳。腹腔镜检查前血清β-hCG水平为1542 mIU/mL，术后第八天升至3163 mIU/mL。甲氨蝶呤和亚叶酸的使用使血清β-hCG水平在72小时内下降了48%，但未能防止输卵管妊娠延迟出血。该病例强调，在持续性异位妊娠治疗期间应持续密切监测，直至血清β-hCG检测不到。
