Lindheim S R, Vidali A, Sauer M V, Timor-Tritsch H
Department of Obstetrics and Gynecology, Columbia University, College of Physicians & Surgeons, New York, New York 10032, USA.
J Assist Reprod Genet. 1997 May;14(5):291-3. doi: 10.1007/BF02765831.
Conservative medical management of ectopic gestations may be difficult in patients with elevated levels of beta-hCG and cardiac activity. This case highlights the difficulty of managing such patients. Doppler flow studies and serum P, if available, should be used and can help determine those patients requiring repeated dosing of methotrexate. Patients using donor gametes and hormonal supplementation who subsequently develop an ectopic gestation may experience "rebound" ovulation, which further clouds the clinical picture. Careful follow-up using serial blood testing and ultrasound study is essential in the correct interpretation of a potentially confusing clinical picture.
对于β-人绒毛膜促性腺激素（β-hCG）水平升高且有心脏活动的异位妊娠患者，保守药物治疗可能会很困难。本病例突出了此类患者管理的难度。如有条件，应使用多普勒血流研究和血清孕酮（P），这有助于确定那些需要重复给予甲氨蝶呤的患者。使用供体配子和激素补充剂后发生异位妊娠的患者可能会出现“反弹”排卵，这会使临床情况更加复杂。通过连续血液检测和超声检查进行仔细随访，对于正确解读可能令人困惑的临床情况至关重要。
