Ectopic Pregnancy
N Engl J Med 2009;361:379-87
Ultrasonographic Examination
Ultrasonographic Findings in Ectopic PregnancyIn gestations longer than 5.5 weeks, a transvaginal ultrasonographic examination should identify an intrauterine pregnancy with almost 100% accuracy.
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Change in the hCG Level in Intrauterine Pregnancy, Ectopic Pregnancy, and Spontaneous Abortion
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Correlation of Ultrasonographic Findings with hCG Values
“Discriminatory hCG value” 1500—3000 mIU/ml
the sensitivity of ultrasonography for the detection of intrauterine pregnancy approaches 100% and at which the absence of an intrauterine pregnancy suggests abnormal or ectopic gestation.
Management
Surgical Management
- Salpingectomy or Salpingostomy
Medical Management
- Intramuscular administration of the Methotrexate
- single-dose or multidose regimen
九十八年 急專考題
有關子宮外孕的臨床特性及診斷,下列敘述何者錯誤?
(A) 危險因子包括曾經發生子宮外孕、輸卵管結紮、人工受孕、和骨盆腔發炎的病史。
(B) 典型的症狀是腹痛、陰道出血、及無月經。
(C) 若尿液懷孕測試陰性就能排除子宮外孕。 X
(D) 病人可能發生危及生命的休克症狀。
(E) 腹痛或腹部不適是最常見的症狀,一般而言是突然的單側劇烈疼痛
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