[Conservative management of extra-uterine pregnancy].
Expectant management was studied in 35 patients representing 4.9% of all ectopic pregnancies during an 8 year period. Laparoscopy was performed in a first period to define the inclusion criteria: hematosalpinx < or = 2 cm and hemoperitoneum < or = 50 ml. In a second period, inclusion criteria used a predictive pretherapeutic score < or = 11 with a sonographic visualization of the ectopic pregnancy. This score involved six criteria graded on a scale from 1 to 3: gestational age, hCG and P level, existence of abdominal pain, size of hemoperitoneum and diameter of hematosalpinx assessed sonographically. The patients were on out-patients basis. Success rate was 85.7% (30/35 patients). When the pretherapeutic score was < or = 11 and the initial hCG level < 1,000 mUl/ml the success rate increased to 96%. Thirteen patients (87%) had patent tubes evaluated by hysterosalpingography on the side of the ectopic pregnancy. Twelve patients delivered one miscarriage occurred and none ectopic pregnancy was observed. Expectant management is a useful form of treatment for ectopic pregnancy in selected cases.
Fernandez
H
H
Service de gynécologie-obstétrique du Pr R. Frydman, Hôpital Antoine-Béclère, Clamart.
Frydman
R
R
D015746:Abdominal Pain / Q000209:etiology; D000553:Ambulatory Care; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007047:Hysterosalpingography; D010535:Laparoscopy; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D011374:Progesterone / Q000097:blood; D012720:Severity of Illness Index; D016216:Ultrasonography, Prenatal
D006063:Chorionic Gonadotropin; D011374:Progesterone
Abstention thérapeutique dans la grossesse extra-utérine.