Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Obstet Gynecol. 2020 Nov;136(5):1001-1005. doi: 10.1097/AOG.0000000000004124.
Patient-centered care is one of the six aims for improvement in health care quality outlined by the National Academy of Medicine (previously known as the Institute of Medicine). We propose an algorithm for patients who are presenting with a pregnancy of unknown location that emphasizes pregnancy desiredness to improve patient-centered care. Health care professionals should assess pregnancy desiredness at a patient's initial consultation for evaluation of pregnancy of unknown location; desiredness, along with other clinical criteria, should guide management. For women with an undesired pregnancy, health care professionals should offer expedient active management. Uterine aspiration will allow for quick clinical diagnosis and resolution of the pregnancy. Alternatively, for women with a desired pregnancy or for those who are ambivalent, we recommend careful conservative management. Adopting this algorithm will recenter the patient in the complex management of pregnancy of unknown location.
以患者为中心的护理是美国国家医学院（前身为医学研究所）提出的改善医疗质量的六个目标之一。我们提出了一种针对妊娠不明位置患者的算法，强调妊娠意愿，以改善以患者为中心的护理。医疗保健专业人员应在患者首次就诊评估妊娠不明位置时评估妊娠意愿；意愿以及其他临床标准应指导管理。对于不希望怀孕的女性，医疗保健专业人员应提供迅速的积极管理。子宫吸引术可以快速进行临床诊断并终止妊娠。或者，对于希望怀孕或有矛盾心理的女性，我们建议谨慎的保守管理。采用这种算法将使妊娠不明位置的复杂管理以患者为中心。
