Departments of Obstetrics and Gynecology and Epidemiology, Perelman School of Medicine at the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Fertil Steril. 2012 Nov;98(5):1061-5. doi: 10.1016/j.fertnstert.2012.09.018.
The evolution of the diagnosis and management of women with an early pregnancy loss has been a success story. The mortality from ectopic pregnancy has objectively been decreased in the past few decades. However, modern management has resulted in a new set of issues. Over-interpretation of a single ultrasound, misunderstanding of the utility of serial hCG values, and inappropriate use of methotrexate can result in iatrogenic complications. Modern management has successfully improved the diagnosis of ectopic pregnancy before rupture; it should now also focus on ensuring that an intrauterine pregnancy is not interrupted as a result of diagnosis and treatment. This article reviews some of the pitfalls of the modern management of early pregnancy failure and introduces a series of articles on the subject.
早期妊娠丢失的诊断和管理的发展是一个成功的范例。过去几十年中，异位妊娠的死亡率客观上有所下降。然而，现代管理带来了一系列新的问题。对单次超声检查的过度解读、对 hCG 连续检测值的作用的误解，以及氨甲喋呤的不当使用，可能导致医源性并发症。现代管理成功提高了异位妊娠破裂前的诊断水平；现在它还应该侧重于确保妊娠不会因诊断和治疗而中断。本文回顾了现代早期妊娠失败管理中的一些陷阱，并介绍了一系列关于该主题的文章。
