[Ectopic pregnancy. I. Diagnostic-therapeutic algorithm used in clinics at the Gynecology Department of the Polish Mother's Memorial Institute].
Zbigniew Pietrzak
Abstract
Zbigniew Pietrzak
Abstract
In prospective study from 1988 to 1992 I analysed possibility of early non-invasive detection and treatment of ectopic pregnancy. In this purpose I used a gynecological examination, estimation of concentration of beta-hCG and progesterone in serum, transvaginal ultrasound and in certain patients, curettage. The fusion of all these methods permits to gain right diagnosis of ectopic pregnancy. In this work I described diagnostic and therapeutic algorithm of ectopic pregnancy allows in using conservative treatment in this pathology. Empty uterus (without gestational sac) in transvaginal ultrasound examination, in cases with beta-hCG concentration is higher than 3000 mIU/ml, allows recognise ectopic pregnancy. I introduced predictive scale for possibilities of conservative treatment and therapeutic algorithm allows to chose way of treatment (laparatomy, laparoscopy, Methotexate i.m. expectant management). The estimation of clinical value of diagnostic algorithm for ectopic pregnancy will present in part II and efficacy of conservative treatment methods in patients with ectopic pregnancy in part III.
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In prospective study from 1988 to 1992 I analysed possibility of early non-invasive detection and treatment of ectopic pregnancy. In this purpose I used a gynecological examination, estimation of concentration of beta-hCG and progesterone in serum, transvaginal ultrasound and in certain patients, curettage. The fusion of all these methods permits to gain right diagnosis of ectopic pregnancy. In this work I described diagnostic and therapeutic algorithm of ectopic pregnancy allows in using conservative treatment in this pathology. Empty uterus (without gestational sac) in transvaginal ultrasound examination, in cases with beta-hCG concentration is higher than 3000 mIU/ml, allows recognise ectopic pregnancy. I introduced predictive scale for possibilities of conservative treatment and therapeutic algorithm allows to chose way of treatment (laparatomy, laparoscopy, Methotexate i.m. expectant management). The estimation of clinical value of diagnostic algorithm for ectopic pregnancy will present in part II and efficacy of conservative treatment methods in patients with ectopic pregnancy in part III.
Key concepts: Ectopic pregnancy, Medicine, Gestational sac, Obstetrics, Curettage, Pregnancy, Laparoscopy, Gynecology