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宫外孕
Ectopic pregnancy
Nature 等信源发布 2024-12-12 23:28
可切换为仅中文
AbstractEctopic pregnancy, defined as the implantation of a developing pregnancy outside of the endometrial cavity of the uterus, is the leading cause of early-pregnancy maternal mortality. The majority of ectopic pregnancies implant in a fallopian tube. Acute complications may include rupture of the fallopian tube or rupture of ectopic pregnancy, haemorrhage and hypovolaemic shock, or occur secondary to treatments such as emergency surgery or blood transfusions, and ultimately increase the risk of maternal death.
摘要异位妊娠定义为在子宫内膜腔外植入发育中的妊娠，是导致早期妊娠孕产妇死亡的主要原因。大多数异位妊娠植入输卵管。急性并发症可能包括输卵管破裂或异位妊娠破裂，出血和低血容量性休克，或继发于紧急手术或输血等治疗，最终增加产妇死亡风险。
After ectopic pregnancy, patients may experience ongoing morbidity, including chronic pain, infertility and psychological distress. Assessment of ectopic pregnancy should focus on prompt diagnosis based on clinical and investigative findings but should also reflect a patient-centred approach with acknowledgement of potential psychological distress associated with pregnancy loss and reduced future fertility.
异位妊娠后，患者可能会持续发病，包括慢性疼痛，不孕症和心理困扰。异位妊娠的评估应侧重于根据临床和调查结果及时诊断，但也应反映以患者为中心的方法，承认与妊娠丢失和未来生育能力降低相关的潜在心理困扰。
Over the last four decades, the foundations of non-invasive diagnosis have been transvaginal sonography and serum β-human chorionic gonadotropin, with diagnostic laparoscopy as a confirmatory test if surgical treatment is planned. Once diagnosed, ectopic pregnancy can be managed expectantly, treated medically with methotrexate or managed surgically.
在过去的四十年中，非侵入性诊断的基础是经阴道超声检查和血清β-人绒毛膜促性腺激素，如果计划进行手术治疗，诊断性腹腔镜检查可作为确诊测试。一旦确诊，异位妊娠可以预期管理，用甲氨蝶呤治疗或手术治疗。
Future fertility is an important but often overlooked aspect in the management of ectopic pregnancy..
未来的生育能力是异位妊娠管理中一个重要但常被忽视的方面。。
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Fig. 1: Anatomic locations of EP.Fig. 2: Ultrasonography features of tubal EP.Fig. 3: Grading of haemoperitoneum.Fig. 4: Algorithm for initial management of early-pregnancy bleeding.Fig. 5: Considerations for the management of ectopic pregnancy.
图1:EP的解剖位置。图2：输卵管EP的超声特征。图3：腹膜出血分级。图4：早期妊娠出血的初始管理算法。图5：异位妊娠管理的考虑因素。
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Download referencesAuthor informationAuthors and AffiliationsDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, AustraliaKrystle Y. Chong & Ben W. MolDepartment of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South AfricaLiesl de WaardThe Ectopic Pregnancy Trust, London, UKMunira OzaCentre for Reproductive Medicine, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, Amsterdam, The NetherlandsMadelon van Wely & Ben W.
下载参考文献作者信息作者和所属机构蒙纳士大学妇产科，澳大利亚维多利亚州克莱顿市Krystle Y.Chong＆Ben W.Mol阿姆斯特丹大学医学与健康科学学院妇产科，南非开普敦Stellenbosch大学，异位妊娠信托基金会，伦敦，UKMunira OzaCentre生殖医学，阿姆斯特丹生殖与发展研究所，阿姆斯特丹UMC，阿姆斯特丹，NetherlandsMadelon van Wely＆Ben W。
MolElizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UKDavor Jurkovic & Maria MemtsaAberdeen Centre for Women’s Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UKAndrea Woolner & Ben W.
MolelizabethGarrett-Anderson妇女健康研究所，伦敦大学学院，伦敦，UKDavor Jurkovic＆MariaMemtsaaberdeen妇女健康研究中心，应用健康科学研究所，医学，医学科学和营养学院，阿伯丁大学，阿伯丁，Ukardrea Woolner＆Ben W。
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PubMed Google ScholarContributionsIntroduction (K.Y.C.); Epidemiology (B.W.M., M.v.W. and L.d.W.); Mechanisms/pathophysiology (D.J.); Diagnosis, screening and prevention (K.Y.C.); Management (K.Y.C. and A.W.); Quality of life (B.W.M. and M.O.); Outlook (M.M.). B.W.M. supervised the project.
PubMed谷歌学术贡献生产（K.Y.C.）；流行病学（B.W.M.，M.v.W.和L.d.W.）；机制/病理生理学（D.J.）；；管理层（K.Y.C.和A.W.）；生活质量（B.W.M.和M.O.）；展望（M.M.）。B、 W.M.监督了该项目。
All authors provided critical feedback and contributed to the final version of the manuscript.Corresponding authorCorrespondence to.
。对应作者对应。
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M.v.W. reports leading the Netherlands Satellite of the Cochrane Gynaecology and Fertility Group. B.W.M. reports grants from the National Health and Medical Research Council, Guerbet and Merck, outside of the submitted work. The other authors declare no competing interests.
M、 v.W.报道领导科克伦妇科和生育小组的荷兰卫星。B、 W.M.报告了国家健康与医学研究委员会、盖尔贝特和默克公司在提交的作品之外提供的资助。其他作者声明没有利益冲突。
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Nature Reviews Disease Primers thanks C. E. Varner, A. Rottenstreich, N. Pereira and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
。Varner，A。Rottenstreich，N。Pereira和另一位匿名审稿人对这项工作的同行评审做出了贡献。
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et al. Ectopic pregnancy..
等。异位妊娠。。
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