Mooij Rob, Geomini Peggy M A J, Bongers Marlies Y
Máxima Medisch Centrum, afd. Gynaecologie en verloskunde, Veldhoven.
Ned Tijdschr Geneeskd. 2014;158:A7831.
An ectopic pregnancy is a pregnancy outside of the uterine cavity. An ectopic pregnancy can rupture and lead to hypovolaemic shock due to intraperitoneal bleeding. We describe 3 cases of women with ectopic pregnancy and discuss the diagnostic and therapeutic options. All women of fertile age with abdominal pain or abnormal vaginal bleeding should get a pregnancy test. Vaginal ultrasound and human chorionic gonadotrophin levels are the most important diagnostic tools. Depending on the findings, management can may be either conservative with repeated follow-up, intramuscular methotrexate or surgical, depending on the findings. After an ectopic pregnancy there is a higher risk of subfertility and another ectopic pregnancy, but more than half of the women will have a subsequent ongoing intra uterine pregnancy.
异位妊娠是指妊娠发生在子宫腔以外。异位妊娠可能破裂,并因腹腔内出血导致低血容量性休克。我们描述了3例异位妊娠女性病例,并讨论了诊断和治疗选择。所有有腹痛或异常阴道出血的育龄女性都应进行妊娠试验。阴道超声和人绒毛膜促性腺激素水平是最重要的诊断工具。根据检查结果,治疗可采用保守治疗(反复随访、肌内注射甲氨蝶呤)或手术治疗,具体取决于检查结果。异位妊娠后,发生不孕和再次异位妊娠的风险更高,但超过一半的女性随后会有持续的宫内妊娠。