2014 年异位妊娠的治疗：一些老问题的新答案。

Treatment of ectopic pregnancies in 2014: new answers to some old questions.

机构信息

Service de Gynécologie Obstétrique, Hôpital Bicêtre, GHU Sud (AP-HP), Le Kremlin Bicêtre, France; Inserm, Centre of Research in Epidemiology and Population Health (CESP), Le Kremlin Bicêtre, France; Faculty of Medicine, University of Paris Sud, Le Kremlin Bicêtre, France.

Inserm, Centre of Research in Epidemiology and Population Health (CESP), Le Kremlin Bicêtre, France.

出版信息

Fertil Steril. 2014 Mar;101(3):615-20. doi: 10.1016/j.fertnstert.2014.01.029.

DOI:10.1016/j.fertnstert.2014.01.029

PMID:24559615

Abstract

Over the past 20 years, a substantial body of research has accumulated about ectopic pregnancy, especially about its epidemiology, risk factors, and diagnosis. Nonetheless, the care of women with these pregnancies remains a topic of debate, and no consensus or guidelines exist to clarify the optimal treatment choices. This review revisits the four primary treatments for ectopic pregnancy and defines and details the concept of "activity," which guides the indications for each treatment. Recent findings of no difference in fertility during the 2 years after an ectopic pregnancy have answered some old questions and raised new ones for determining the optimal management of ectopic pregnancies. Most especially, they allow the consideration and weighing of a wider range of factors, including the woman's own preferences as well as efficacy and the monitoring time until recovery.

摘要

在过去的 20 年中，积累了大量关于异位妊娠的研究，特别是关于其流行病学、危险因素和诊断。尽管如此，这些妊娠的妇女的护理仍然是一个有争议的话题，也没有共识或指南来阐明最佳治疗选择。本综述重新审视了异位妊娠的四种主要治疗方法，并定义和详细说明了“活性”的概念，该概念指导了每种治疗方法的适应症。最近发现异位妊娠后 2 年内的生育能力没有差异，这回答了一些旧问题，并为确定异位妊娠的最佳管理提出了新问题。最重要的是，它们允许考虑和权衡更广泛的因素，包括妇女自身的偏好以及疗效和恢复监测时间。