Robinson H P, de Crespigny L J, Harvey J, Hay D L
Aust N Z J Obstet Gynaecol. 1985 Feb;25(1):49-53. doi: 10.1111/j.1479-828x.1985.tb00602.x.
The ultrasound findings from 260 patients with a clinical suspicion of ectopic pregnancy have been analysed and correlated with the results of urine pregnancy tests and tests of serum LH and/or HCG levels. Most importantly in a practical clinical context, it was found that a negative serum test virtually excludes an ectopic pregnancy, and an empty uterus with an adnexal mass and/or the presence of free fluid together with a positive urine test gives a very high probability of an ectopic pregnancy. The absolute diagnosis of an ectopic pregnancy by the demonstration of a living fetus outside the uterus is an uncommon finding (8%). Conversely, an empty uterus alone on ultrasound examination in the absence of other ultrasound findings in those patients with a positive serum test is not a reliable guide to the presence of an ectopic pregnancy unless there is an irrefutable conception date at least 5 weeks previously. It is recommended that pathology laboratories and ultrasound departments establish absolute levels of HCG above which an intrauterine pregnancy should always be visible within the uterus. Given appropriate attention to the clinical condition of the patient, the combined use of diagnostic ultrasound, simple urine pregnancy tests and serum assays of beta HCG levels goes a long way to discriminating between those patients with and those without an ectopic pregnancy.
对260例临床怀疑异位妊娠患者的超声检查结果进行了分析，并与尿妊娠试验及血清促黄体生成素（LH）和/或人绒毛膜促性腺激素（HCG）水平检测结果进行了关联分析。在实际临床情况下，最重要的是发现血清检测结果为阴性实际上可排除异位妊娠，而子宫空虚伴附件包块和/或有游离液体且尿妊娠试验呈阳性，则异位妊娠的可能性非常高。通过在子宫外发现存活胎儿来确诊异位妊娠的情况并不常见（8%）。相反，在血清检测呈阳性的患者中，超声检查仅见子宫空虚而无其他超声表现时，除非有至少5周前的确切受孕日期，否则不能作为异位妊娠存在的可靠指标。建议病理实验室和超声科确定HCG的绝对水平，超过该水平时子宫内妊娠应始终在子宫内可见。在适当关注患者临床状况的情况下，联合使用诊断性超声、简单的尿妊娠试验和血清β-HCG水平检测，对于区分有异位妊娠和无异位妊娠的患者大有帮助。
