Fylstra D L
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston 29425, USA.
Obstet Gynecol Surv. 1998 May;53(5):320-8. doi: 10.1097/00006254-199805000-00024.
Ectopic pregnancy accounts for 2 percent of all pregnancies in the United States, and contributes substantially to maternal morbidity and mortality. Risk factors for the development of ectopic pregnancy are described, but less than 50 percent of women with ectopic pregnancy actually give a history of such risk factors. The initial history and physical examination of patients who eventually are found to have ectopic pregnancy can be misleading, resulting in early misdiagnosis. Failure to diagnose ectopic pregnancy before tubal rupture limits treatment options. However, with a high index of suspicion, and a combination of biochemical and ultrasound parameters, early diagnosis of ectopic pregnancy can be achieved, permitting medical or conservative surgical treatment options. Future reproductive potential after treatment of ectopic pregnancy is limited, with only approximately one third of affected women ever subsequently delivering a live-born infant. Future fertility is more dependent on the condition of the contralateral fallopian tube than on the specific type of therapy used to treat the affected tube. There is no consensus on which treatment is most effective, minimizing the risk of persistent ectopic pregnancy, while providing the optimum future fertility potential.
在美国，异位妊娠占所有妊娠的2%，并在很大程度上导致孕产妇发病和死亡。虽然描述了异位妊娠发生的风险因素，但实际上只有不到50%的异位妊娠女性有此类风险因素的病史。最终被诊断为异位妊娠的患者最初的病史和体格检查可能会产生误导，导致早期误诊。在输卵管破裂前未能诊断出异位妊娠会限制治疗选择。然而，通过高度的怀疑指数以及生化和超声参数的结合，可以实现异位妊娠的早期诊断，从而允许采用药物或保守手术治疗方案。异位妊娠治疗后的未来生殖潜力有限，只有大约三分之一的受影响女性随后能活产婴儿。未来生育能力更多地取决于对侧输卵管的状况，而非用于治疗患侧输卵管的具体治疗类型。对于哪种治疗最有效，既能将持续性异位妊娠的风险降至最低，又能提供最佳的未来生育潜力，目前尚无共识。
