Clinical Analysis Of 5 Cases With Persistent Ectopic Pregnancy

OBJECTIVE:To evaluate the risk factors, diagnosis, treatment and prevention of persistent ectopic pregnancy.METHODS:Clinical data of 29 cases with PEP from between Jan 1st,2010 and Feb 29th,2016 at Zhejiang University School of Medicine Obstetrics & Gynecology, choose 5 cases for typical cases, analysis of the risk factors, diagnostic criteria, treatment and preventive measures of persistent ectopic pregnancy(PEP).RESULTS:Case 1:41 days,has a salpingectomy after the diagnosis of interstitial tubal pregnancy,8days after the diagnosis of persistent ectopic pregnancy (PEP), follow-up take MTX 20mg* 5d treatment failure, diverted to the uterine horn wedge resection treatment success.Case 2:47 days, has a salpingotomy after the diagnosis of tubal pregnancy (miscarriage),3 days after the diagnosis ofPEP, follow-up take MTX75mg treatment success. Case 3:51 days,has a salpingotomy after the diagnosis of tubal pregnancy (miscarriage),6 days after the diagnosis of PEP, follow-up take MTX 20mg * 5d treatment success. Case 4:60 days, has a salpingectomy after the diagnosis of ectopic pregnancy, but surgery showed no lesions and ectopic pregnancy villi,3 days after the diagnosis of PEP, follow-up take MTX 75mg treatment success. Case 5:43 days,has medical treatement after the diagnosis ofectopic pregnancy,35 days after the diagnosis of PEP,follow-up take a salpingectomy success.CONCLUSION:Special type of ectopic pregnancy, miscarriage/ruptured tubal pregnancy conservative surgery, preoperative serum human chorionic gonadotropin(HCG) abnormally high values, take cilia out complete or not and pelvic adhesions, corpus luteum cyst occurs whether continued presence are the persistent ectopic pregnancy risk factors. If the risk factors mentioned above preoperative, we need a high degree of vigilance, preventive measures to minimize its incidence. For the patient has a clear diagnosis of PEP, you need a good grasp of drugs and surgical treatment indications of PEP after surgery secondary preferred MTX conservative treatment, PEP after drug treatment, according to HCG to choose surgery or take MTX treatment again.