Murphy Robert, Jahnke Krista, Houry Debra
Emory University School of Medicine, Atlanta, Georgia 30303 , USA.
South Med J. 2008 Aug;101(8):797-9. doi: 10.1097/SMJ.0b013e31817bea05.
The purpose of this study was to determine presenting signs/symptoms and risk factors in emergency department (ED) patients ultimately diagnosed with molar pregnancy.
A retrospective review of ED medical records using a standardized abstraction sheet was conducted over a 10-year period (1995-2005) from three EDs.
Records were available on 44 patients (mean age 25.2 years, 75% African-American) with a diagnosis of molar pregnancy who had been seen in the ED. Almost half presented with abdominal pain, nausea/vomiting, and/or vaginal bleeding. Forty-three percent had a history of sexually transmitted disease; 41% had a history of abdominal or gynecological surgery; and three patients had a documented prior molar pregnancy. Of 22 ultrasounds performed, 68% were noted to have a molar pregnancy. Only five patients had molar pregnancy listed in the differential diagnosis at their initial visit.
Patients who presented with molar pregnancy tended to be young, multiparous, and African-American. The most common presenting complaint was vaginal bleeding, and the ultrasound was not diagnostic of molar pregnancy in almost one-third of the cases.
本研究旨在确定最终被诊断为葡萄胎妊娠的急诊科（ED）患者的就诊体征/症状及危险因素。
采用标准化摘要表，对来自三个急诊科的10年期间（1995 - 2005年）的ED病历进行回顾性研究。
有44例诊断为葡萄胎妊娠的患者在急诊科就诊的病历资料可供分析（平均年龄25.2岁，75%为非裔美国人）。近一半患者表现为腹痛、恶心/呕吐和/或阴道出血。43%有性传播疾病史；41%有腹部或妇科手术史；3例有既往葡萄胎妊娠记录。在进行的22次超声检查中，68%被发现为葡萄胎妊娠。初诊时只有5例患者的鉴别诊断中列出了葡萄胎妊娠。
表现为葡萄胎妊娠的患者往往年轻、多产且为非裔美国人。最常见的就诊主诉是阴道出血，近三分之一的病例中超声检查不能诊断为葡萄胎妊娠。
