Kemmann E, Trout S, Garcia A
Division of Reproductive Endocrinology/Fertility, Department of Obstetrics and Gynecology, UMD-Robert Wood Johnson Medical School, 303 George Street, Suite 250, New Brunswick, NJ 08901, USA.
J Am Assoc Gynecol Laparosc. 1994 Feb;1(2):122-6. doi: 10.1016/s1074-3804(05)80774-1.
To identify factors that may predict patients at increased risk for persistent ectopic pregnancy after linear salpingotomy, we analyzed demographic, surgical, and biochemical variables retrospectively in 60 women who underwent laparoscopic linear salpingotomy, and compared data in those who developed persistent ectopic pregnancy (study group) versus those who were cured (controls). The two groups were similar with respect to demographic features and surgical findings. They did not differ significantly in gestational age and human chorionic gonadotropin (hCG) levels at time of surgery. There was, however, a significant difference in hCG dynamics when the average daily increase in the week before surgery was analyzed. Eleven (18%) women developed persistent ectopic pregnancy. The disorder did not occur in those whose hCG levels were flat or declining, whereas patients whose levels increased more than 40% per day had a significantly greater risk. In addition, at surgery, tubal bleeding was significantly more common in study patients than in controls (55 vs 9%, p <0.001). We conclude that hCG dynamics in the week before salpingotomy, and bleeding activity at surgery may identify patients who are the most likely candidates for persistent ectopic pregnancy.
为了确定可能预测行输卵管线性切开术后持续性异位妊娠风险增加的患者的因素，我们对60例行腹腔镜输卵管线性切开术的女性患者的人口统计学、手术和生化变量进行了回顾性分析，并比较了发生持续性异位妊娠的患者（研究组）和治愈患者（对照组）的数据。两组在人口统计学特征和手术结果方面相似。他们在手术时的孕周和人绒毛膜促性腺激素（hCG）水平上没有显著差异。然而，在分析手术前一周的平均每日增幅时，hCG动态变化存在显著差异。11名（18%）女性发生了持续性异位妊娠。hCG水平持平或下降的患者未出现这种情况，而hCG水平每天增加超过40%的患者风险显著更高。此外，在手术中，研究组患者输卵管出血明显比对照组更常见（55%对9%，p<0.001）。我们得出结论，输卵管切开术前一周的hCG动态变化以及手术时的出血情况可能有助于识别最有可能发生持续性异位妊娠的患者。
