Stabile Guglielmo, Zinicola Giulia, Romano Federico, Buonomo Francesca, Mangino Francesco Paolo, Ricci Giuseppe
Institute for Maternal and Child Health IRCCS "Burlo Garofolo", 34137 Trieste, Italy.
Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy.
Diagnostics (Basel). 2020 Aug 31;10(9):652. doi: 10.3390/diagnostics10090652.
Non-tubal ectopic pregnancies (NT-EPs) are rare but potentially life-threatening conditions. The incidence ranges are between 5-8.3% of all ectopic pregnancies. For this retrospective observational study, 16 patients with NT-EP and treated from January 2014 to May 2020 were recruited. Demographic details, symptoms, Beta human chorionic gonadotrophin (β-hCG) levels, ultrasound findings, management and treatment outcomes were presented. In hemodynamically stable patients, diagnosis was made using ultrasounds and β-hCG levels. Laparoscopy was essential to identify and remove the ectopic pregnancy in clinical unstable patients. A radical laparoscopic approach was chosen in one case of cervical pregnancy diagnosed late in the first trimester. Medical treatment and minimally invasive procedure, alone or combined, resulted in effective strategies in asymptomatic women with an early diagnosis of NT-EP. We report cases of cervical pregnancies successfully treated by hysteroscopy alone or combined with medical treatment, the first case of scar pregnancy treated by mini-reseptoscope and curettage and the fifth case of interstitial pregnancy treated with Methotrexate and Mifepristone. In this manuscript we report a single center experience in the management of NT-EPs with the aim of outlining the importance of the early diagnosis for a minimally invasive treatment in order to reduce maternal morbidity and mortality and preserve future fertility.
非输卵管异位妊娠（NT-EP）虽罕见，但可能危及生命。其发生率占所有异位妊娠的5%-8.3%。在这项回顾性观察研究中，招募了2014年1月至2020年5月期间接受治疗的16例NT-EP患者。呈现了人口统计学细节、症状、β-人绒毛膜促性腺激素（β-hCG）水平、超声检查结果、管理及治疗结果。对于血流动力学稳定的患者，通过超声和β-hCG水平进行诊断。对于临床不稳定的患者，腹腔镜检查对于识别和切除异位妊娠至关重要。对于一例在孕早期晚期诊断出的宫颈妊娠患者，选择了根治性腹腔镜手术方法。单独或联合使用药物治疗和微创手术，对于早期诊断为NT-EP的无症状女性是有效的治疗策略。我们报告了单独通过宫腔镜或联合药物治疗成功治疗宫颈妊娠的病例、首例通过微型宫腔镜和刮宫术治疗瘢痕妊娠的病例以及第五例通过甲氨蝶呤和米非司酮治疗间质部妊娠的病例。在本手稿中，我们报告了一个单中心管理NT-EP的经验，目的是概述早期诊断对于微创治疗的重要性，以降低孕产妇发病率和死亡率并保留未来生育能力。
