An ectopic pregnancy (EP) is defined as any pregnancy that occurs outside the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. The goal of this retrospective study is to address medical...An ectopic pregnancy (EP) is defined as any pregnancy that occurs outside the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. The goal of this retrospective study is to address medical and conservative surgical management of unruptured fallopian tube EP as an effective manner to preserve tubes to prevent secondary infertility. This study was conducted between January 1, 2010, and April 30, 2024, in Ponni Hospital, Madurai. It included 319 women, out of 6248 pregnant women diagnosed with ectopic pregnancy by using an Inexecreen kit, trans-abdominal scan, trans-vaginal scan, and doubling of beta-human chorionic gonadotropin (β-HCG) in 48 hours and Magnetic Resonance Imaging (MRI). Medical and conservative surgical management were given to those patients effectively. Out of 319 patients, 62 patients (19.4%) had a ruptured ectopic pregnancy and underwent surgical treatment;257 patients (80.6%) had an unruptured ectopic pregnancy. The conservative medical management was provided to 257 patients. Out of 257 patients, 235 patients were treated by injecting methotrexate and folic acid rescue when the criteria were met. 14 patients had salpingostomy and injection methotrexate (Inj. Methotrexate) and inj. Prostaglandin F2 alpha was administered into the tubal wall to preserve tubes. 8 patients had a live ectopic pregnancy;for those patients, Inj. Methotrexate was injected into the gestational sac through ultrasound guidance. 225 out of 257 patients reached out to us to seek fertility treatment;the remaining 32 patients were not seeking fertility. All fertility-seeking patients had successful pregnancies. We lost follow-up of 12 patients in this study. Out of 213 patients who came for fertility treatment, a 76.1% success rate was achieved with live birth, the recurrent ectopic pregnancy rate was 13.6%, the miscarriage and stillbirth rates were 10.3%. 32 patients, who were not seeking fertility, had quality life without surgical scars for ectopic pregnancy and cost-effective treatment. 25 patients out of 32 had laparoscopic sterilization later, and 7 patients followed temporary contraception as per our advice. This clinical data was retrieved from medical records.展开更多
目的本研究主要采用经阴道彩色多普勒(Transvaginal Color Doppler,TVCD)超声检测早早孕期间患者子宫内膜螺旋动脉显示率,探查早早孕患者双侧输卵管动脉血流动力学差异。方法选择我院妇产科门诊和住院病人中早早孕患者99例。TVCD超声诊...目的本研究主要采用经阴道彩色多普勒(Transvaginal Color Doppler,TVCD)超声检测早早孕期间患者子宫内膜螺旋动脉显示率,探查早早孕患者双侧输卵管动脉血流动力学差异。方法选择我院妇产科门诊和住院病人中早早孕患者99例。TVCD超声诊断仪检测子宫内膜厚度、螺旋动脉、观察双侧子宫动脉输卵管支血流,并采用脉冲多普勒检测舒张期最小血流速度(End Diastolic Velocity,EDV)、阻力指数(Resistance Index,RI)、动脉峰值流速(Peak Systolic Velocity,PSV)。比较螺旋动脉显示率及双侧输卵管动脉的血流参数,并将检测结果与最终妊娠结果进行对照分析。结果99例中,42例为宫内妊娠,38例为输卵管妊娠,19例为宫内早孕流产。3组子宫内膜厚度比较,宫内妊娠组子宫内膜厚度比异位妊娠组和自然流产组厚,有显著性差异(P<0.05),自然流产组和异位妊娠组比较无差异(P>0.05)。42例宫内妊娠中,27例子宫内膜内显示螺旋动脉,显示率为64.2%;38例异位妊娠患者中,1例内膜中有动脉血流信号显示,显示率为3.0%;自然流产组显示率为26.3%,3组螺旋动脉显示率差异有统计学意义(P<0.05)。异位妊娠组中患侧EDV高于对侧、RI低于对侧,其差异有统计学意义(P<0.05);而宫内妊娠组和自然流产组双侧输卵管动脉血流动力学参数差异均无统计学意义(P>0.05)。结论TVCD检测早早孕期间螺旋动脉显示率可提高异位妊娠的诊断率;滋养细胞的异位种植可以增加其周围组织血流供应。应用TVCD可在早早孕期间探测螺旋动脉和输卵管动脉的血流动力学改变,从而为异位妊娠的诊断提供更多的临床信息。展开更多
文摘An ectopic pregnancy (EP) is defined as any pregnancy that occurs outside the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. The goal of this retrospective study is to address medical and conservative surgical management of unruptured fallopian tube EP as an effective manner to preserve tubes to prevent secondary infertility. This study was conducted between January 1, 2010, and April 30, 2024, in Ponni Hospital, Madurai. It included 319 women, out of 6248 pregnant women diagnosed with ectopic pregnancy by using an Inexecreen kit, trans-abdominal scan, trans-vaginal scan, and doubling of beta-human chorionic gonadotropin (β-HCG) in 48 hours and Magnetic Resonance Imaging (MRI). Medical and conservative surgical management were given to those patients effectively. Out of 319 patients, 62 patients (19.4%) had a ruptured ectopic pregnancy and underwent surgical treatment;257 patients (80.6%) had an unruptured ectopic pregnancy. The conservative medical management was provided to 257 patients. Out of 257 patients, 235 patients were treated by injecting methotrexate and folic acid rescue when the criteria were met. 14 patients had salpingostomy and injection methotrexate (Inj. Methotrexate) and inj. Prostaglandin F2 alpha was administered into the tubal wall to preserve tubes. 8 patients had a live ectopic pregnancy;for those patients, Inj. Methotrexate was injected into the gestational sac through ultrasound guidance. 225 out of 257 patients reached out to us to seek fertility treatment;the remaining 32 patients were not seeking fertility. All fertility-seeking patients had successful pregnancies. We lost follow-up of 12 patients in this study. Out of 213 patients who came for fertility treatment, a 76.1% success rate was achieved with live birth, the recurrent ectopic pregnancy rate was 13.6%, the miscarriage and stillbirth rates were 10.3%. 32 patients, who were not seeking fertility, had quality life without surgical scars for ectopic pregnancy and cost-effective treatment. 25 patients out of 32 had laparoscopic sterilization later, and 7 patients followed temporary contraception as per our advice. This clinical data was retrieved from medical records.
