Alalade Aderemi Olaoluwa, Smith Fredrick John Ennis, Kendall Charlotte Emma, Odejinmi Funlayo
a Department of Obstetrics and Gynaecology , Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board , Wrexham , UK.
b Cochrane Medical Education Centre, Institute of Medical Education, Cardiff University School of Medicine, Cardiff University , Cardiff , UK.
J Obstet Gynaecol. 2017 Nov;37(8):982-991. doi: 10.1080/01443615.2017.1323852. Epub 2017 Jun 20.
Recent advances in ultrasonography and the use of other modalities including magnetic resonance imaging scans have led to the early and more accurate diagnosis of non-tubal ectopic pregnancies (NTE). As a result, the management of these pregnancies has evolved. This article addresses the management options currently available for NTE. While surgical management remains the mainstay of treatment for ovarian, abdominal and cornual ectopics, there is growing evidence that some of these can be managed medically. Many authors have utilised a combination of medical and surgical approaches in the management of cervical and caesarean section (CS) scar ectopic pregnancies with good outcome. The availability of dedicated early pregnancy units has further improved diagnosis and more importantly the follow-up care for these patients. The rarity of cases and the difficulty of ethically organising randomised trials for NTE remain a problem in formulating consistent pathways for optimum management of women with NTE.
超声检查以及包括磁共振成像扫描在内的其他检查手段的最新进展，已实现对非输卵管异位妊娠（NTE）的早期且更准确的诊断。因此，这些妊娠的管理方式也有所发展。本文探讨了目前可用于NTE的管理方案。虽然手术管理仍是卵巢、腹腔和宫角异位妊娠的主要治疗方式，但越来越多的证据表明其中一些情况可以通过药物治疗。许多作者在宫颈和剖宫产（CS）瘢痕异位妊娠的管理中采用了药物和手术相结合的方法，效果良好。专门的早期妊娠诊疗单元的设立进一步改善了诊断，更重要的是改善了对这些患者的后续护理。病例的罕见性以及在伦理上组织NTE随机试验的困难，仍然是为NTE女性制定最佳管理的一致路径时面临的一个问题。
