Papageorgiou Dimitrios, Sapantzoglou Ioakeim, Prokopakis Ioannis, Zachariou Eleftherios
Department of Gynecology, Athens Naval and Veterans Hospital, 115 21 Athens, Greece.
1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, 106 79 Athens, Greece.
Biomedicines. 2025 Jun 13;13(6):1465. doi: 10.3390/biomedicines13061465.
The most frequent form of ectopic pregnancy, known as tubal pregnancy, leads to a dangerous situation where the fertilized ovum implants inside a fallopian tube, which can result in tubal rupture and severe bleeding. The purpose of this narrative review is to evaluate all existing data regarding epidemiology, risk factors, pathophysiology, clinical presentation, diagnosis, and management of tubal ectopic pregnancy in order to provide a comprehensive understanding of this common yet difficult clinical condition. Prior ectopic pregnancy, together with tubal pathology and assisted reproduction, represent the main risk factors for this condition. The diagnosis relies on serial β-hCG tests combined with transvaginal ultrasonography, but laparoscopy serves as the diagnostic tool for cases with uncertain results. The treatment plan depends on the fallopian tube integrity, along with the patient's hemodynamic condition. Patients with unruptured pregnancies who are hemodynamically stable receive methotrexate treatment as the preferred option, but surgical intervention with salpingectomy or salpingostomy becomes necessary in case of tubal rupture or when medical treatment fails. The development of laparoscopic procedures has led to better results and improved possibilities for fertility preservation. The psychological effects on patients require both counseling and follow-up care. Early detection, along with personalized management, helps decrease maternal complications and optimize reproductive outcomes.
最常见的异位妊娠形式，即输卵管妊娠，会导致一种危险情况，即受精卵植入输卵管内，这可能导致输卵管破裂和严重出血。本叙述性综述的目的是评估关于输卵管异位妊娠的流行病学、危险因素、病理生理学、临床表现、诊断和管理的所有现有数据，以便全面了解这种常见但棘手的临床病症。既往异位妊娠，连同输卵管病变和辅助生殖，是这种病症的主要危险因素。诊断依靠连续的β-人绒毛膜促性腺激素（β-hCG）检测结合经阴道超声检查，但对于结果不确定的病例，腹腔镜检查是诊断工具。治疗方案取决于输卵管的完整性以及患者的血流动力学状况。妊娠未破裂且血流动力学稳定的患者首选甲氨蝶呤治疗，但在输卵管破裂或药物治疗失败时，输卵管切除术或输卵管造口术的手术干预是必要的。腹腔镜手术的发展带来了更好的治疗效果，并提高了保留生育能力的可能性。对患者的心理影响需要咨询和后续护理。早期检测以及个性化管理有助于减少孕产妇并发症并优化生殖结局。
