Laparoscopic Management of 42 Cases of Tubal Stump Pregnancy and Postoperative Reproductive Outcomes
Laparoscopic Management of 42 Cases of Tubal Stump Pregnancy and Postoperative Reproductive Outcomes
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42例输卵管残端妊娠腹腔镜处理及术后生育效果
DOI：
10.1016/j.jmig.2019.04.030
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发表时间：
2020-03-01
影响因子：
4.1
通讯作者：
Xu, Hong
中科院分区：
文献类型：
--
作者：
Sun, Feng;Yang, SiQin;Xu, Hong
研究目的：输卵管残端妊娠是异位妊娠的一种罕见变异。本研究的目的是评估腹腔镜手术治疗输卵管残端妊娠并调查术后妊娠结局。设计：回顾性研究。地点：大学附属医院。患者：诊断为输卵管残端妊娠的患者（n = 42）。干预措施：从医院电子病历系统中提取数据。测量和主要结果：纳入2010年6月至2018年7月诊断为输卵管残端妊娠的患者。数据包括人口特征、妊娠和产次、盆腔手术史、临床特征和治疗。所有手术均通过腹腔镜进行。术后妊娠结局通过电子病历或电话确定。患者的平均年龄为 30 岁（范围为 21-39 岁）。 42例输卵管残端妊娠中，有12例（28.6%）在手术时宫外孕破裂。其余30例术中残端妊娠完整。患者平均随访 31 个月（范围 10-60）个月。 39 名患者中的 33 名获得了随访数据（其中 3 名异位输卵管残端妊娠患者未纳入随访数据，因为所有患者均顺利产下且不希望未来怀孕）。 28 名尝试受孕的患者中有 18 名 (64.3%) 在随访期间发生宫内妊娠 (IUP)；在这 18 例 IUP 中，14 例 (77.8%) 实现了活产。 1例单胎妊娠20(+5)周子宫破裂导致胎儿死亡。 18 例 IUP 中的 3 例 (16.7%) 在妊娠早期以自然流产结束。结论：腹腔镜手术是输卵管残端妊娠的可行选择，并且与良好的妊娠结局相关。 (C) 2019 年 AAGL。版权所有。
Study Objective: Tubal stump pregnancy is a rare variant of ectopic pregnancy. The aim of this study was to evaluate laparoscopic surgery for tubal stump pregnancy and to investigate postoperative pregnancy outcomes.Design: Retrospective study.Setting: University-affiliated hospital.Patients: Patients (n = 42) diagnosed with tubal stump pregnancy.Interventions: Data were extracted from the electronic medical records system of the hospital.Measurements and Main Results: Patients diagnosed with tubal stump pregnancy between June 2010 and July 2018 were included. Data included demographic characteristics, gravidity and parity, history of pelvic surgery, clinical features, and treatment. All procedures were laparoscopic. Postoperative pregnancy outcomes were identified from electronic medical records or by telephone. Patients' mean age was 30 (range, 21-39) years. Twelve of 42 tubal stump pregnancies (28.6%) had ruptured ectopic pregnancy at the time of operation. The remaining 30 cases had intact stump pregnancy during surgery. Patients were followed for a mean of 31 (range, 10-60) months. Follow-up data were available for 33 of 39 patients (3 with heterotopic tubal stump pregnancy were not included in follow-up data because all resulted in a live births and had no desire for future pregnancy). Eighteen of 28 patients (64.3%) who attempted conception had intrauterine pregnancies (IUPs) during the follow-up period; of these 18 IUPs, 14 (77.8%) resulted in live births. There was 1 case of uterine rupture in a singleton pregnancy at 20(+5) weeks that resulted in fetal death. Three of 18 IUPs (16.7%) ended in the first trimester with spontaneous abortions.Conclusion: Laparoscopic surgery is a feasible option for tubal stump pregnancy and is associated with favorable pregnancy outcomes. (C) 2019 AAGL. All rights reserved.