| Objective: Tubal pregnancy is a common women disease during their reproduction, approximate accounting for 95% of ectopic pregnancy. Recently, It,s incidence has increased dramatically. In the past, a radical salpingectomy was usually performed in the treatment. Recently, with the rapid development of Transvaginal sonography, measurement of serum and urine chorionic gonadotropin concentration and laparoscopic technology, early diagnosis of ectopic pregnancies was allowed. It was important to conservative treatment from early eighty age. At present, it has been a important way to treat tubal pregnancy. But with the progress of early diagnosis of ectopic pregnancy and the strong requirement for preserving fertility, the adaptation could not be fit for clinical requirment that the approch of medical conservative treatment of ectopic pregnancy was being applied. (if patient is the stable life circumstance and isn't activity entorrhagia , serum chorionic gonadotropin is below 2000mIu/ml and adnexal mass size is less than 3cm).and Only adnexal mass size is evaluated by general B-mode ultrasound, but more information about embryonic vitality cannot be supplied, so it often happens that the case cannot be selected exactly .This leads to persistent ectopic pregnancy happening, about 3%-20%,which is related to trophoblastic activity and not cleaning it out completely。We discovered that tubal pregnancy rupture is because trophoblast cells invade into the above of tubal muscularis layer in histopathology study. chorionic gonadotropin is a mark of trophoblastic amount and activity. By colour Doppler flow imaging the blood flow characteristic is shown when oosperm implants tubal. The subject will study the differences of serum chorionic gonadotropin ,RI and S/D of tubal mass by CDFI among three stages of trophoblastic invading into tubal layer and their correlation, in order to supply reference for conservation treatment. Methods: 1) All color sonograms was performed for patients before operation. The mean resistance index (RI) and systolic/diastolic(S/D) were calculated for adnexal mass when at least five sequential, good quality waveforms were obtained. 2) gathering samples: (1) 3ml blood sample was drawn in elbow at 30 minutes before surgery and was centrifugated for 10 minutes, then the serum was get and was stored in –20oc refrigerator. (2) The tubal sample was fixed in 10%formalin during operation. 3)Assaying serum: serum β-hCG concentrations were estimated using ELISA (DSL,USA). The intra-and inter-assay coefficients of variation for this assay are 3.0 and 2.3%, respectively, at concentrations above 0.4ug/L. Two are 15±5ug/L and 85±20ug/L, respectively .standardsamples, quality control samples and serum samples was estimated according to operating steps on reagent box specification. ( β-hCG below 3.1ug/L is normal ) .4) Histopathology: (1) cutting materials: The tubal was slit along longitudinal axes and 4-5 blocks was cut vertically at implantation site or suspect site represented. It was noticed to cut all layers.(2)paraffin-embedded material was made into sections that were stained by hematoxylin and eosin.(3) The depth that trophoblastic cells invaded into tubal wall(×40) and cellular form(×400) was determined with light microscope.The stages was classified according to the depth.( According to the standard of reference No. 2 ). Results: 1) The classification of the depth of trophoblastic cell invading into the tubal wall ,( see figure 1). The number of the different stages was seen in table 1. First stage (fig.1A): trophoblastic cell only invaded into mucosa layer. Second stage (fig.1B): trophoblastic cell invaded into muscular layer. Third stage (fig.1C): trophoblastic cell invaded into serosal layer. 2 The result shows that the data is abnormal distribution, so Kruskal-Wallis was used to compare the differences in β-hCG, RI, S/D among three stages. Comparisons among three stages demonstrated hCG. (P<0.05) and no significant differences in the RI and S/D. (P>0.05). (see table 1.).3 RI and S/D was downside...
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