Broad ligament pregnancy is a rare event and always delays in diagnosis. A pregnant woman in early twenties presented for our center. Routine ultra-sonography revealed a first trimester abdominal pregnancy. Broad liga...Broad ligament pregnancy is a rare event and always delays in diagnosis. A pregnant woman in early twenties presented for our center. Routine ultra-sonography revealed a first trimester abdominal pregnancy. Broad ligament pregnancy was diagnosed intraoperation and treated with laparoscopic resection successfully. The patient has a history of right tubal pregnancy 2 years ago and terminated with Laparoscopic Salpingostomy. According to the long term followed-up for the patient, we found that she had recurrent right tubal pregnancy 5 months after the broad ligment ectopic pregnancy. She received the salpingectomy laparoscopically. We presented the case to discuss the clinical management of broad ligament ectopic pregnancy and options of surgical treatments of tubal pregnancy to reduce the risk of recurrent.展开更多
Objective: To compare the effects of treatment of tubal pregnancy (TP)and its following second pregnancy by intratubal methotrexate injection(IMI) alone and combination of IMI with Chinese herbal medicine. Methods: Th...Objective: To compare the effects of treatment of tubal pregnancy (TP)and its following second pregnancy by intratubal methotrexate injection(IMI) alone and combination of IMI with Chinese herbal medicine. Methods: Thirty-five patients suffering from unruptured TP were divided into two groups at random, to the 19 patients in the treated group, the treatment of combined IMI with Ectopic Pregnancy decoction No. 2 (EP2, a traditional Chinese medical decoction) was applied, and to the other 16 patients in the control group, IMI alone was applied for control. Serum concentrations of human chorionic gonadotro-pinβ(β-HCG), size of the gestational sac, existent time of fetal cardiac beat and peritoneal fluid were measured before and after treatment. And hysterosalpingography were performed 6 months after ending the treatment to verify the presence of tubal obstruction and the condition of relapse.Results: The treatment of all the 35 women was successful. The recovery duration of serumβ-HCG, disappearance duration of TP sac and existent time of peritoneal fluid in the treated group were 20.0±7. 8 days, 1.2±0. 7 months and 10. 7±2. 9 days respectively, which were significantly different from those in the control group (24. 4 ±8.1 days, 3.6±1.7 months and 19.1±3. 2 days respectively(P<0. 05, P<0.01 and P<0. 05 respectively), but the existent time of fetal cardiac beat in the two groups (8.8±1. 9 days vs 9.0±1. 3 days) was not significantly different (P>0.05). The post-treatment oviduct obstructive rate in the two groups was 10.5% and 43.8% respectively, that in the treatment group was less significant (P<0.05). The relapse rate of EP in the treatment group was insignificantly different from that in the control group (5.3% vs 18.8%, P>0.05). Conclusion: The two therapies (IMI alone and IMI combined with EP2) could obtain e-qual efficacy in curing TP. Compared with IMI alone, the combined therapy appears to have the effects of accelerating the resorption of gestational sac and peritoneal fluid, improving the patency of fallopian tube and ameliorating the circumstance of pregnancy, which is favorable to improvement of the re-pregnancy rate and reduction of the re-occurrence of ectopic pregnancy as well as to the enhancement of the effect of IMI in killing trophocytes. But there is not enough proof to show the potency of EP2 in killing embryo.展开更多
A 34-year-old woman came into the Emergency Department of PUMCH with the complaint of sudden lower abdominal pain lasting 4 hours on May 1st, 2004. She had normal menstruation cycle with a period of 30 days. But her l...A 34-year-old woman came into the Emergency Department of PUMCH with the complaint of sudden lower abdominal pain lasting 4 hours on May 1st, 2004. She had normal menstruation cycle with a period of 30 days. But her last menstruation was started 37 days ago. She experienced laparosalpingectomy for right tubal pregnancy on Jan. 23rd, 2003. During that operation, it was found that she had pelvic adhesions in the Douglas pouch.展开更多
目的:评价异位妊娠在MTX保守治疗过程中发生破裂出血的危险因素。方法:回顾性分析100例MTX保守治疗的异位妊娠妇女,主要测量指标为血浆HCG水平。结果:异位妊娠MTX保守治疗前、后HCG水平的上升速度与输卵管破裂出血密切相关;保守治疗给药...目的:评价异位妊娠在MTX保守治疗过程中发生破裂出血的危险因素。方法:回顾性分析100例MTX保守治疗的异位妊娠妇女,主要测量指标为血浆HCG水平。结果:异位妊娠MTX保守治疗前、后HCG水平的上升速度与输卵管破裂出血密切相关;保守治疗给药前48 h HCG上升超过66%或给药后HCG仍持续性升高,则提示输卵管破裂可能性大;65%异位妊娠破裂出血在峡部。结论:MTX治疗前、后HCG上升的速度是预示输卵管破裂出血的良好指标;保守治疗给药前HCG上升速度超过66%/48 h或用药后HCG仍持续性升高,提示可能需要外科手术治疗;妊娠囊的着床部位也是输卵管破裂的高危因素。展开更多
文摘Broad ligament pregnancy is a rare event and always delays in diagnosis. A pregnant woman in early twenties presented for our center. Routine ultra-sonography revealed a first trimester abdominal pregnancy. Broad ligament pregnancy was diagnosed intraoperation and treated with laparoscopic resection successfully. The patient has a history of right tubal pregnancy 2 years ago and terminated with Laparoscopic Salpingostomy. According to the long term followed-up for the patient, we found that she had recurrent right tubal pregnancy 5 months after the broad ligment ectopic pregnancy. She received the salpingectomy laparoscopically. We presented the case to discuss the clinical management of broad ligament ectopic pregnancy and options of surgical treatments of tubal pregnancy to reduce the risk of recurrent.
文摘Objective: To compare the effects of treatment of tubal pregnancy (TP)and its following second pregnancy by intratubal methotrexate injection(IMI) alone and combination of IMI with Chinese herbal medicine. Methods: Thirty-five patients suffering from unruptured TP were divided into two groups at random, to the 19 patients in the treated group, the treatment of combined IMI with Ectopic Pregnancy decoction No. 2 (EP2, a traditional Chinese medical decoction) was applied, and to the other 16 patients in the control group, IMI alone was applied for control. Serum concentrations of human chorionic gonadotro-pinβ(β-HCG), size of the gestational sac, existent time of fetal cardiac beat and peritoneal fluid were measured before and after treatment. And hysterosalpingography were performed 6 months after ending the treatment to verify the presence of tubal obstruction and the condition of relapse.Results: The treatment of all the 35 women was successful. The recovery duration of serumβ-HCG, disappearance duration of TP sac and existent time of peritoneal fluid in the treated group were 20.0±7. 8 days, 1.2±0. 7 months and 10. 7±2. 9 days respectively, which were significantly different from those in the control group (24. 4 ±8.1 days, 3.6±1.7 months and 19.1±3. 2 days respectively(P<0. 05, P<0.01 and P<0. 05 respectively), but the existent time of fetal cardiac beat in the two groups (8.8±1. 9 days vs 9.0±1. 3 days) was not significantly different (P>0.05). The post-treatment oviduct obstructive rate in the two groups was 10.5% and 43.8% respectively, that in the treatment group was less significant (P<0.05). The relapse rate of EP in the treatment group was insignificantly different from that in the control group (5.3% vs 18.8%, P>0.05). Conclusion: The two therapies (IMI alone and IMI combined with EP2) could obtain e-qual efficacy in curing TP. Compared with IMI alone, the combined therapy appears to have the effects of accelerating the resorption of gestational sac and peritoneal fluid, improving the patency of fallopian tube and ameliorating the circumstance of pregnancy, which is favorable to improvement of the re-pregnancy rate and reduction of the re-occurrence of ectopic pregnancy as well as to the enhancement of the effect of IMI in killing trophocytes. But there is not enough proof to show the potency of EP2 in killing embryo.
文摘A 34-year-old woman came into the Emergency Department of PUMCH with the complaint of sudden lower abdominal pain lasting 4 hours on May 1st, 2004. She had normal menstruation cycle with a period of 30 days. But her last menstruation was started 37 days ago. She experienced laparosalpingectomy for right tubal pregnancy on Jan. 23rd, 2003. During that operation, it was found that she had pelvic adhesions in the Douglas pouch.
文摘目的:评价异位妊娠在MTX保守治疗过程中发生破裂出血的危险因素。方法:回顾性分析100例MTX保守治疗的异位妊娠妇女,主要测量指标为血浆HCG水平。结果:异位妊娠MTX保守治疗前、后HCG水平的上升速度与输卵管破裂出血密切相关;保守治疗给药前48 h HCG上升超过66%或给药后HCG仍持续性升高,则提示输卵管破裂可能性大;65%异位妊娠破裂出血在峡部。结论:MTX治疗前、后HCG上升的速度是预示输卵管破裂出血的良好指标;保守治疗给药前HCG上升速度超过66%/48 h或用药后HCG仍持续性升高,提示可能需要外科手术治疗;妊娠囊的着床部位也是输卵管破裂的高危因素。
