早期腹腔异位妊娠保守治疗成功经验及文献复习

Successful methotrexate management of early abdominal pregnancy and literature review

腹腔妊娠发生率极低,可危及孕妇生命。早期诊断及治疗对于其预后影响极大。B超医师对β-HCG(+)、宫腔及双侧附件区未见明显孕囊的情况,应加大检查范围,可结合核磁共振(MRI)早期诊断特殊部位的腹腔异位妊娠。在患者生命体征稳定、具备急诊手术的条件下,可尝试保守治疗,并根据患者的病情变化及时调整治疗方案。本例患者停经9周诊断为腹腔异位妊娠,伴有胎心搏动,使用甲氨蝶呤(MTX)肌内注射后69dβ-HCG降至正常,治疗后10月余正常妊娠。

Abdominal pregnancy is a rare localization of ectopic pregnancy. With persistently rising β-HCG levels and no pregnancy identified in the uterus or pelvis,there should be a thorough evaluation of the entire pelvis and abdomen. Magnetic resonance imaging（MRI）is a useful tool for locating such an ectopic pregnancy. Early diagnosis and treatment are advised and the choice of treatment is crucial. This report reveals a 9-week abdominal pregnancy and the ectopic pregnancy＇s management conservatively with maternal methotrexate administration only. This treatment option should be considered in the management of this potentially life-threatening condition.