Alouini S, Mesnard L, Coly S, Dolique M, Lemaire B
Département de chirurgie gynécologique et obstétrique, CHR Orléans, 1, Porte-Madeleine, 45000 Orléans, France.
J Gynecol Obstet Biol Reprod (Paris). 2012 Feb;41(1):48-54. doi: 10.1016/j.jgyn.2011.08.004. Epub 2011 Sep 22.
To evaluate the type and the emergency degree of the pathologies met in gynecological emergencies.
prospective study including 205 patients presented to the Emergency department of a maternity level 3 between the 2011 January 4 and February 15.
One hundred and ninety-four patients (95%) came from their own initiative. One hundred and eighty-one patients (88%) consulted for abdominal/pelvic or lumbar pain and or metrorragia. The mean age of the patients was of 31 ± 11 years and the average waiting time before being examined was of 84 ± 101 minutes. For 94 patients (46%), the diagnosis was an asymptomatic intra-uterine pregnancy in 41 cases or associated with minor symptoms. 21 patients (8.9%) consulted for menstruation with or without dysmenorrhea, 17 (8,3%) had a miscarriage, 14 (7%) a genital infection, 11 (5%) an ovarian pathology and eight (4%) an ectopic pregnancy or its follow-up. Seven patients had an axillary lymphocele or a breast tumor and four symptomatic myomas. Six patients presented with non-gynecological pathologies. In 23 cases (11%) no organic cause was found. Only 24 patients (12%) were hospitalized and nine (4.5%) operated.
Most of the patients consulted for minor obstetrical or gynecological pathologies without relation with the function of Emergency department. Ectopic pregnancy remains a rare event. Better information of the users on the significance of the urgency is desirable. Consultation of a referent physician before emergency services should be privileged.
评估妇科急症中所遇病症的类型及紧急程度。
前瞻性研究,纳入2011年1月4日至2月15日期间在一家三级产科急诊就诊的205例患者。
194例患者(95%)为主动前来就诊。181例患者(88%)因腹部/盆腔或腰部疼痛和/或子宫出血前来咨询。患者的平均年龄为31±11岁,接受检查前的平均等待时间为84±101分钟。94例患者(46%)的诊断为无症状宫内妊娠,其中41例为单纯无症状宫内妊娠,或伴有轻微症状。21例患者(8.9%)因月经问题前来咨询,有或无痛经,17例(8.3%)发生流产,14例(7%)有生殖器感染,11例(5%)有卵巢病变,8例(4%)为异位妊娠或其随访情况。7例患者有腋窝淋巴管瘤或乳腺肿瘤,4例有症状性肌瘤。6例患者患有非妇科病症。23例(11%)未发现器质性病因。仅24例患者(12%)住院,9例(4.5%)接受手术。
大多数患者因轻微产科或妇科病症前来咨询,与急诊科功能无关。异位妊娠仍然是罕见事件。需要更好地向患者告知紧急情况的重要性。在急诊服务前应优先咨询专科医生。