Shalev E, Peleg D, Tsabari A, Romano S, Bustan M
Department of Obstetrics and Gynecology, Central Emek Hospital, Afula, Israel.
Fertil Steril. 1995 Jan;63(1):15-9. doi: 10.1016/s0015-0282(16)57289-6.
To determine the characteristics and long-term outcome of women succeeding or failing expectant management of ectopic pregnancy (EP).
Prospective, defined protocol.
University-affiliated gynecology department.
We used a protocol that selected women with laparoscopic confirmed ectopic tubal pregnancy and declining plasma hCG values. Over a 5-year period, 60 women representing 20.1% of EPs fulfilled the inclusion criteria. Women were followed with serial hCG testing and transvaginal ultrasound.
Success or failure of expectant management.
Expectant management was successful in 28 (47.7%) of the patients. Thirty-two (53.3%) failed expectant management, and a treatment procedure was required. There was no difference in the resultant ipsilateral tubal patency or 1-year fertility rates of those women succeeding or failing expectant management. Analysis showed that in the face of declining values and with a starting hCG > 2,000 mIU/mL (conversion to SI unit, 1.00), 93.3% failed expectant management, whereas < 2,000 mIU/mL, 60.0% succeeded.
We conclude that expectant management should be offered as a treatment option only in those women fulfilling the criteria for a good prognosis.
确定异位妊娠（EP）期待治疗成功或失败的女性的特征及长期结局。
前瞻性、明确方案。
大学附属妇产科。
我们采用一种方案，选取经腹腔镜确诊为输卵管异位妊娠且血β-人绒毛膜促性腺激素（hCG）值下降的女性。在5年期间，60名女性（占异位妊娠患者的20.1%）符合纳入标准。对这些女性进行连续hCG检测和经阴道超声检查。
期待治疗的成功或失败。
28例（47.7%）患者期待治疗成功。32例（53.3%）期待治疗失败，需要进行治疗。期待治疗成功或失败的女性，其患侧输卵管通畅情况及1年生育率并无差异。分析表明，当hCG值下降且起始hCG>2000 mIU/mL（换算为国际单位制，1.00）时，93.3%的患者期待治疗失败；而当hCG<2000 mIU/mL时，60.0%的患者期待治疗成功。
我们得出结论，仅应将期待治疗作为一种治疗选择提供给那些符合预后良好标准的女性。
