Ramirez N C, Lawrence W D, Ginsburg K A
Department of Pathology, Hutzel Hospital-Detroit Medical Center, Wayne State University School of Medicine, Michigan, USA.
J Reprod Med. 1996 Oct;41(10):733-40.
To compare the past and current clinical and pathologic factors that are responsible for ectopic pregnancy (EP).
We performed a retrospective chart and histopathologic specimen review of 740 cases of EP during a recent, five-year period. Products of conception, as well as 240 cases of concomitant endometrial biopsies, were examined.
The mean age at presentation, proportion of patients with a history of pelvic inflammatory disease, voluntary interruption of pregnancy (VIP), previous surgery and laterality (right side) of the tubal EP were similar to rates reported in previous studies. Ninety-four percent of the EPs were tubal, and 90% of the tubes exhibited some pathologic changes, including chronic salpingitis (49.5%) and follicular salpingitis (10%), among others. Gestational endometrial patterns were seen in 44% of cases. The corpus luteum of pregnancy was contralateral in 30% of cases in which an ovarian biopsy was performed.
The factors classically associated with EP remained similar over a period of about 50 years, although the association with VIP still appears to be controversial. Endometrial curettage alone cannot be used to exclude an EP. Ovum transmigration may play a role in the genesis of EP.
比较过去和当前导致异位妊娠（EP）的临床和病理因素。
我们对最近五年期间的740例EP病例进行了回顾性病历和组织病理学标本审查。检查了妊娠产物以及240例同期子宫内膜活检病例。
就诊时的平均年龄、有盆腔炎病史的患者比例、人工流产史、既往手术史以及输卵管EP的侧别（右侧）与先前研究报告的发生率相似。94%的EP为输卵管妊娠，90%的输卵管呈现出一些病理变化，包括慢性输卵管炎（49.5%）和滤泡性输卵管炎（10%）等。44%的病例可见妊娠子宫内膜模式。在进行卵巢活检的病例中，30%的病例妊娠黄体位于对侧。
在大约50年的时间里，与EP经典相关的因素仍然相似，尽管与人工流产的关联似乎仍存在争议。仅靠刮宫不能排除EP。卵子游走可能在EP的发生中起作用。
