Arora R, Rathore A M, Habeebullah S, Oumachigui A
Department of Obstetrics and Gynaecology, Jawaharlal Nehru Institute of Postgraduate Medical Education and Research, Pondicherry.
J Indian Med Assoc. 1998 Feb;96(2):53-4, 57.
This study is an attempt to have an overall view of the changing trends in the clinical presentation, diagnostic modalities and management of ectopic pregnancy over a period of three and a half decades. The incidence of ectopic pregnancy was one in 368 during the 15-year period from 1959-1973 (group A) and has increased to one in 160 during the latter part of the study period from 1988-1993 (group B). Medical termination of pregnancy, abortion, intra-uterine contraceptive device and previous tubal ligation were the important risk factors recently (group B). Unruptured tubal pregnancy was diagnosed in 9.8% (group B) as compared to only 3% in group A. However, as most of the patients came to the hospital with disturbed pregnancy, the use of ultrasonography and urine gravindex test was helpful in only 14% in the latter part of the study. The characteristic clinical features like pain abdomen with amenorrhoea, vaginal bleeding and positive culdocentesis were the most reliable diagnostic criteria in both the groups. There is an increasing trend towards conserving the tubes and methotrexate use recently.
本研究旨在全面了解35年期间异位妊娠的临床表现、诊断方法及治疗的变化趋势。1959年至1973年的15年期间（A组），异位妊娠的发病率为1/368，而在研究后期1988年至1993年（B组），发病率已增至1/160。药物流产、人工流产、宫内节育器及既往输卵管结扎是近期重要的危险因素（B组）。未破裂输卵管妊娠在B组中的诊断率为9.8%，而A组仅为3%。然而，由于大多数患者因妊娠异常前来医院就诊，在研究后期，超声检查和尿妊娠试验仅对14%的患者有帮助。两组中，诸如腹痛伴闭经、阴道出血及后穹窿穿刺阳性等典型临床特征都是最可靠的诊断标准。近期，保留输卵管及使用甲氨蝶呤的趋势不断增加。
