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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
|
| pubmed:dateCreated |
1985-9-19
|
| pubmed:abstractText |
The diagnosis of ectopic pregnancy has become precise and reliable. Consequently, the management of ectopic pregnancy has progressed to the point where the physician is often able to preserve fertility. Therefore, conservative surgery is indicated if the patient desires future fertility and conditions are appropriate. The combination of ultrasound, beta-hCG pregnancy testing, and laparoscopy has led to a rising incidence of diagnosed ectopic pregnancy prior to rupture. This has greatly facilitated the use of the conservative approach to the management of tubal pregnancy. Although ectopic pregnancy can be diagnosed early and managed conservatively, it is, and will remain a potentially life-threatening disease and must be approached as such. Table 3 summarizes our proposed surgical management of tubal pregnancy. Table 4 summarizes the results of conservative surgery for tubal pregnancy.
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| pubmed:keyword |
http://linkedlifedata.com/resource/pubmed/keyword/Adnexal Effects,
http://linkedlifedata.com/resource/pubmed/keyword/Bacterial And Fungal Diseases,
http://linkedlifedata.com/resource/pubmed/keyword/Contraception,
http://linkedlifedata.com/resource/pubmed/keyword/Diseases,
http://linkedlifedata.com/resource/pubmed/keyword/Endoscopy,
http://linkedlifedata.com/resource/pubmed/keyword/Evaluation Methodology,
http://linkedlifedata.com/resource/pubmed/keyword/Examinations And Diagnoses,
http://linkedlifedata.com/resource/pubmed/keyword/Family Planning,
http://linkedlifedata.com/resource/pubmed/keyword/Genital Effects, Female,
http://linkedlifedata.com/resource/pubmed/keyword/Incidence,
http://linkedlifedata.com/resource/pubmed/keyword/Infections,
http://linkedlifedata.com/resource/pubmed/keyword/Iud,
http://linkedlifedata.com/resource/pubmed/keyword/LAPAROSCOPY,
http://linkedlifedata.com/resource/pubmed/keyword/Laboratory Examinations And Diagnoses,
http://linkedlifedata.com/resource/pubmed/keyword/Laboratory Procedures,
http://linkedlifedata.com/resource/pubmed/keyword/Measurement,
http://linkedlifedata.com/resource/pubmed/keyword/Obstetrical Surgery,
http://linkedlifedata.com/resource/pubmed/keyword/PREGNANCY, TUBAL,
http://linkedlifedata.com/resource/pubmed/keyword/PREGNANCY TESTS,
http://linkedlifedata.com/resource/pubmed/keyword/Pelvic Infections,
http://linkedlifedata.com/resource/pubmed/keyword/Physical Examinations And Diagnoses,
http://linkedlifedata.com/resource/pubmed/keyword/Pregnancy,
http://linkedlifedata.com/resource/pubmed/keyword/Pregnancy, Ectopic--etiology,
http://linkedlifedata.com/resource/pubmed/keyword/Pregnancy Complications,
http://linkedlifedata.com/resource/pubmed/keyword/Pregnancy Tests, Immunologic,
http://linkedlifedata.com/resource/pubmed/keyword/Reproduction,
http://linkedlifedata.com/resource/pubmed/keyword/Surgery,
http://linkedlifedata.com/resource/pubmed/keyword/Treatment,
http://linkedlifedata.com/resource/pubmed/keyword/Tubal Effects,
http://linkedlifedata.com/resource/pubmed/keyword/Tubal Motility Effects,
http://linkedlifedata.com/resource/pubmed/keyword/ULTRASONICS,
http://linkedlifedata.com/resource/pubmed/keyword/Urogenital Effects
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jun
|
| pubmed:issn |
0009-9201
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
28
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
365-74
|
| pubmed:dateRevised |
2009-11-11
|
| pubmed:otherAbstract |
PIP: The presentation, diagnosis, and treatment of ectopic pregnancy are reviewed. The current trend in treatment of tubal ectopic pregnancy is toward preservation of reproductive function whenever possible. The incidence of ectopic pregnancy has not increased as much over the past several years as some reports indicate; the discrepancy is due to bias introduced by excluding numbers of abortions from the denominators. Pelvic inflammatory disease (PID) is the principal etiologic factor in ectopic pregnancy, and Neisseria gonorrhoeae is the causative agent in most primary tubal infection. Patients with previous abdominal surgery, a history of PID, or who use IUDs have more ectopic pregnancies. The clinical presentation of ectopic pregnancy is variable, and women may be asymptomatic. Any sexually active woman with abnormal bleeding, abdominal pain, or an adnexal mass should be examined immediately to rule out ectopic pregnancy. Culdocentesis may be used to determine whether intraperitoneal hemorrhage is present. The beta human chorionic gonadotropin (hCG) radioimmunoassay is unsurpassed as an endocrine test for diagnosis of ectopic pregnancy, but is time consuming. Diagnostic laparoscopy should not be postponed if a ruptured ectopic gestation is suspected. Ultrasound identification of an intrauterine gestational sac and a serum concentration of beta hCG that exceeds 6500 IU/1 rules out ectopic pregnancy. A sonographically normal uterus and a serum concentration of beta hCG that does not exceed 6500 IU/1 is highly indicative of ectopic pregnancy. Diagnostic laparoscopy to confirm the presence of tubal pregnancy has become routine since technical improvements restored interest in the laparoscope in the early 1960s. Early diagnosis is crucial for preservation of fertility. When a tubal pregnancy is diagnosed, the physician must choose a radical or conservative approach based on the patient's immediate medical condition and desire for future fertility as well as the surgeon's experience. Salpingectomy is the procedure of choice if a fallopian tube is irreparably damaged or if there is a hemoperitoneum associated with shock or profuse bleeding. Rigorous cornual resection is not recommended because it does not exclude a subsequent interstitial pregnancy and may also weaken the myometrium. Colpotomy is rarely indicated, and the removal of a normally functioning ipsilateral ovary is unwarranted. If a conservative approach is feasible, salpingostomy and closure by secondary intention is preferred over salpingotomy and primary closure, which may be complicated by bleeding and edema. Fimbrial evacuation is the easiest procedure but has the highest number of undesirable effects. Midsegment anastomosis, tubouterine implantation, and the Gepfert procedure are either controversial or are associated with poor prognoses. Of all conservative procedures, only salpingostomy offers better results in term pregnancy rates than the radical operations. Salpingectomy is the most efficient treatment for tubal gestation if the patient does not desire future fertility.
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| pubmed:meshHeading |
pubmed-meshheading:2410172-Chorionic Gonadotropin,
pubmed-meshheading:2410172-Chorionic Gonadotropin, beta Subunit, Human,
pubmed-meshheading:2410172-Fallopian Tubes,
pubmed-meshheading:2410172-Female,
pubmed-meshheading:2410172-Fertility,
pubmed-meshheading:2410172-Humans,
pubmed-meshheading:2410172-Ovary,
pubmed-meshheading:2410172-Pelvic Inflammatory Disease,
pubmed-meshheading:2410172-Peptide Fragments,
pubmed-meshheading:2410172-Pregnancy,
pubmed-meshheading:2410172-Pregnancy, Ectopic,
pubmed-meshheading:2410172-Pregnancy, Tubal,
pubmed-meshheading:2410172-Rh Isoimmunization,
pubmed-meshheading:2410172-Risk,
pubmed-meshheading:2410172-Ultrasonography,
pubmed-meshheading:2410172-Uterus
|
| pubmed:year |
1985
|
| pubmed:articleTitle |
Ectopic pregnancy.
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| pubmed:publicationType |
Journal Article
|