Oancea Mihaela, Ciortea Razvan, Diculescu Doru, Poienar Alexandra-Andreea, Grigore Mihaela, Lupean Roxana-Adelina, Nicula Renata, Chira Diana, Strilciuc Stefan, Mihu Dan
Department of Obstetrics and Gynaecology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
Department of Obstetrics and Gynaecology, 'Grigore T Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.
Medicina (Kaunas). 2020 Nov 30;56(12):665. doi: 10.3390/medicina56120665.
: Spontaneous heterotopic pregnancy (SHP) is a rare condition represented by the synchronous coexistence of an intrauterine and an ectopic pregnancy. It rarely occurs with natural conception and is usually a consequence of assisted reproductive techniques. Diagnosis of SHP can be a challenge for the clinician. The evolution of the intrauterine pregnancy is dependent on many factors, such as the location of the heterotopic pregnancy, gestational age at the time of diagnosis, the surgical procedure, the presence of other risk factors, early or delayed management. The aim of this systematic review of the literature was to extract existing evidence on spontaneous heterotopic pregnancy with otherwise unaffected intrauterine pregnancy. : From a total of 1907 database entries identified in PubMed, EMBASE and Cochrane reviews, we selected 18 papers for narrative synthesis, for which we explored the diagnostic options, treatment, and outcome of these extremely rare epidemiologic occurrences. Manuscripts were assessed using the CARE guidelines for reporting case reports. : The main symptom was abdominal pain, and the preferred treatment approach was surgical, more precisely, using a laparoscopic approach. Most cases presented no risk factors, and the diagnosis was mostly made in the first semester. : Normal follow-up and evolution of intrauterine pregnancy have been observed regardless of surgical approach (open or laparoscopic). Early diagnosis and treatment are advised, as they impact maternal and fetal outcomes. Evidence on this topic is scarce, predominantly comprised of case reports with variable degrees of adherence to dissemination guidelines. More studies on this topic are required to optimize care protocols for this type of pregnancy.
自发性异位妊娠（SHP）是一种罕见的情况，表现为宫内妊娠和异位妊娠同时并存。它很少在自然受孕时发生，通常是辅助生殖技术的结果。对临床医生来说，SHP的诊断可能是一项挑战。宫内妊娠的发展取决于许多因素，如异位妊娠的位置、诊断时的孕周、手术方式、是否存在其他风险因素、管理的早晚。本系统文献综述的目的是提取关于宫内妊娠未受其他影响的自发性异位妊娠的现有证据。：在PubMed、EMBASE和Cochrane综述中确定的总共1907条数据库条目中，我们选择了18篇论文进行叙述性综合分析，我们探讨了这些极其罕见的流行病学事件的诊断选择、治疗方法和结果。使用报告病例报告的CARE指南对手稿进行评估。：主要症状是腹痛，首选的治疗方法是手术，更确切地说是采用腹腔镜手术。大多数病例没有风险因素，诊断大多在孕早期做出。：无论采用何种手术方式（开放手术或腹腔镜手术），都观察到宫内妊娠有正常的随访和发展情况。建议早期诊断和治疗，因为它们会影响母婴结局。关于这个主题的证据很少，主要由对传播指南遵循程度不同的病例报告组成。需要更多关于这个主题的研究来优化这类妊娠的护理方案。
