我们是否忽视了米非司酮在输卵管异位妊娠的药物治疗中的作用？
Have we overlooked the role of mifepristone for the medical management of tubal ectopic pregnancy?
机构信息
Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
出版信息
Hum Reprod. 2023 Aug 1;38(8):1445-1448. doi: 10.1093/humrep/dead116.
Ectopic pregnancy is a risk of both spontaneous and assisted reproduction pregnancies. The majority of ectopic pregnancies abnormally implant within a fallopian tube (extrauterine pregnancies). In haemodynamically stable women, medical or expectant treatment can be offered. Currently accepted medical treatment is using a drug called methotrexate. However, methotrexate has potential adverse effects, and a significant proportion of women will still require emergency surgery (up to 30%) to remove the ectopic pregnancy. Mifepristone (RU-486) has anti-progesterone effects and has a role in managing intrauterine pregnancy loss and termination of pregnancy. On reviewing the literature and given progesterone's pivotal role in sustaining pregnancy, we propose that we may have overlooked the role of mifepristone in the medical management of tubal ectopic pregnancy in haemodynamically stable women.
宫外孕是自然妊娠和辅助生殖妊娠的风险。大多数宫外孕异常植入输卵管内（子宫外妊娠）。对于血流动力学稳定的妇女，可以提供医疗或期待治疗。目前接受的医疗治疗是使用一种叫做甲氨蝶呤的药物。然而，甲氨蝶呤有潜在的不良反应，而且相当一部分妇女仍需要紧急手术（高达 30%）来切除宫外孕。米非司酮（RU-486）具有抗孕激素作用，在管理宫内妊娠丢失和终止妊娠方面有一定作用。在回顾文献并考虑到孕激素在维持妊娠中的关键作用后，我们提出，我们可能忽略了米非司酮在血流动力学稳定的妇女的输卵管宫外孕的医疗管理中的作用。
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