Popp L W, Colditz A, Gaetje R
Clinic Dr. Guth, Juergensallee, Hamburg, Germany.
Int J Gynaecol Obstet. 1994 Mar;44(3):239-44. doi: 10.1016/0020-7292(94)90173-2.
Management of early ectopic pregnancy was investigated in a multicenter, prospective study.
Serum beta-hCG levels were monitored after therapy and correlated to the type of management, gestational age, and initial serum beta-hCG levels in 119 patients with ectopic pregnancies detected at 5-7 postmenstrual weeks.
Salpingectomy was performed in 16 patients. No post-operative complications were reported. After conservative laparoscopic surgery of 51 ectopic pregnancies, 9 (18%) had delayed decrease or an increase of serum beta-hCG levels. Re-operations were performed in 4 (7%) patients. Similar findings were noted in 2/6 patients after conservative operations performed by laparotomy. Intrachorionic injection treatment was successful in 17/18 ectopic pregnancies, and expectant management in 7/8 patients with initial serum beta-hCG levels below 250 mIU/ml.
Persistence of trophoblastic activity is a potential complication of conservative surgical treatment of ectopic pregnancy. A detailed diagnosis as early as 6-7 post-menstrual weeks may be the key for future non-surgical management of ectopic pregnancy.
在一项多中心前瞻性研究中对早期异位妊娠的管理进行调查。
对119例在月经周期第5 - 7周检测出异位妊娠的患者进行治疗后监测血清β - hCG水平，并将其与管理类型、孕周和初始血清β - hCG水平相关联。
16例患者接受了输卵管切除术。未报告术后并发症。在对51例异位妊娠进行保守性腹腔镜手术后，9例（18%）患者血清β - hCG水平下降延迟或升高。4例（7%）患者进行了再次手术。在剖腹进行保守手术后的6例患者中有2例出现类似结果。18例异位妊娠中17例经绒毛膜内注射治疗成功，7例初始血清β - hCG水平低于250 mIU/ml的患者进行了期待治疗。
滋养层细胞活性持续存在是异位妊娠保守手术治疗的潜在并发症。早在月经周期第6 - 7周进行详细诊断可能是未来异位妊娠非手术管理的关键。
