Cacciatore B, Korhonen J, Stenman U H, Ylöstalo P
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
Ultrasound Obstet Gynecol. 1995 May;5(5):297-300. doi: 10.1046/j.1469-0705.1995.05050297.x.
We studied sonographic findings and levels of human chorionic gonadotropin (hCG) in 71 patients with a presumed ectopic pregnancy, recruited for conservative management, to find out whether these parameters may be useful in monitoring treatment. Patients were selected on the basis of decreasing hCG levels, minimal symptoms and an adnexal mass, suggestive of ectopic pregnancy, of < or = 5 cm at transvaginal sonography. In 49 (69%) patients the ectopic pregnancy resolved spontaneously: the adnexal mass resolved significantly more slowly than did hCG levels. In 22 (31%) of the cases laparoscopy was required after an average of 9 days, because of worsening clinical symptoms. The initial size of the ectopic pregnancy did not significantly differ between the two groups, but it increased constantly in the laparoscopy group. The number of patients with free pelvic fluid also increased significantly in the laparoscopy group, whereas blood flow patterns at admission and during follow-up did not differ between the two groups. A decrease in ectopic pregnancy size at day 7 had a sensitivity of 84% and a specificity of 100% in predicting spontaneous resolution. Transvaginal sonography monitoring appears useful in recognizing the ectopic pregnancies most likely to resolve spontaneously without complications.
我们研究了71例拟行保守治疗的疑似异位妊娠患者的超声检查结果及人绒毛膜促性腺激素（hCG）水平，以确定这些参数是否有助于监测治疗。入选患者的依据是hCG水平下降、症状轻微且经阴道超声检查提示异位妊娠的附件包块≤5 cm。49例（69%）患者的异位妊娠自然消退：附件包块消退的速度明显慢于hCG水平下降的速度。22例（31%）患者因临床症状恶化，平均9天后需行腹腔镜检查。两组患者异位妊娠的初始大小无显著差异，但腹腔镜检查组的异位妊娠大小持续增加。腹腔镜检查组盆腔游离液体的患者数量也显著增加，而两组患者入院时及随访期间的血流模式无差异。第7天异位妊娠大小减小对预测自然消退的敏感性为84%，特异性为100%。经阴道超声监测似乎有助于识别最有可能自然消退且无并发症的异位妊娠。
