Diagnosis and treatment of tubal pregnancy
10.3760/cma.j.issn.1008-6315.2011.12.039
- VernacularTitle:输卵管妊娠的临床诊治分析
- Author:
Yan HAO
- Publication Type:Journal Article
- Keywords:
Tubal pregnancy;
Ultrasound;
Laparoscope
- From:
Clinical Medicine of China
2011;27(12):1327-1330
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical features of tubal pregnancy and summarize the diagnosis and treatment.Methods The clinical data of 287 cases were reviewed including routine test,ultrasound examination,and laparoscopic surgery.The clinical features and indicators of surgery were evaluated,193 cases treated by laparoscopic surgery and 94 cases treated by traditional surgery.Results ( 1 ) The major clinical manifestations of tubal pregnancy were abdominal pain ( 100% ),menopause ( 80.8% ) and irregular vaginal bleeding (62.4%).(2) By ultrasound examination mass was found in 257 cases (89.5% ),and pelvic cavity accumulates liquid in 167 cases (58.2% ).In accessories division 32 cases ( 11.1% ) had blastocyst and 19 cases (6.6% ) had embryo or fetal heart.The positive rate of urine pregnancy test was 86.4%,and the average level of blood 3-HCG was (545.0 ± 231.6) U/L.( 3 ) The past medical history was as follows:Tirty-four cases ( 11.8% ) with ligation or other method of contraception,43 cases ( 15.0% ) with surgery,87 cases (30.3% )with artiflcal abortion,and 33 cases ( 11.5% ) with hepatitis,malaria or tuberculosis.(4)All the surgery succeed with an average surgery time of (44.5 ± 6.7 ) min.Ninety-seven cases were treated with blood transfusion and there were no complications.Operative wound of all patients were healed first term,and the time stay in hospital was (4.1 ± 2.7 ) d,and the levels of blood β-HCG all dropped ≥50% by 24 h after surgery.Conclusion ( 1 ) Abdominal pain,menopause,and irregular vaginal bleeding are the major clinical manifestations of tubal pregnancy.(2)The best method of diagnosis in tubal pregnancy is blood β-HCG and ultrasound examination.(3) Laparoscopic gynaecological surgery has such merits as minimal invasion,and it is the best way for diagnosis and treatment of tubal pregnancy.