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An investigation of the time trends, risk factors, role of ultrasonic preoperative diagnosis of 79 ovarian pregnancy.

探讨术前超声诊断 79 例卵巢妊娠的时间趋势、危险因素、作用。

  • 影响因子:2.02
  • DOI:10.1007/s00404-020-05648-6
  • 作者列表:"Zheng JH","Liu MD","Zhou XJ","Zhang ML","Ma YM","Wang W","Huang XH
  • 发表时间:2020-06-18
Abstract

BACKGROUND:Ovarian pregnancy (OP) is a rare form of ectopic pregnancy and is still a medical challenge. Therefore, more studies about the time trends, risk factors and diagnostic measurements are needed for the efficient treatment of OP. METHODS:The datum of OP patients who were treated at the Second Hospital of Hebei Medical University from 2003 to 2018 was collected and a retrospective cohort study was preformed between OP and tubal pregnancy. RESULTS:79 of all 6943 ectopic pregnancy (1.14%) were OP. The prevalence of OP following assisted reproductive technology showed an increasing trend over time, from 8.33% to 15.22%. Previous abdominal surgery was one of the risk factors of OP (OR 0.41, 95% CI 0.18-0.95, p = 0.04). Merely 2 (2.53%) patients were sonographically diagnosed as OP accorded with their discharge diagnosis. However, 56 (80.0%) accumulation of blood in the pelvis formed echo free areas could be clearly found by ultrasonography. A significant difference was found in serum β-hCG level among OP patients and tubal pregnancy patients (2762.73 ± 1915.24 mmol/L vs 1034.20 ± 915.32 mmol/L, p < 0.001). CONCLUSIONS:The prevalence of OP following assisted reproductive technology is on the rise. History of abdominal surgery may be a high risk factor for OP patients who have the tendency of high β-hCG levels. The ultrasonic preoperative diagnosis is conductive to the early diagnosis of OP though the diagnosis accuracy is low.

摘要

背景: 卵巢妊娠 (OP) 是一种罕见的异位妊娠,仍然是一个医学挑战。因此,OP 的有效治疗需要更多关于时间趋势、危险因素和诊断测量的研究。 方法: 收集 2003 年至 2018 年在河北医科大学第二医院就诊的 OP 患者资料,对 OP 与输卵管妊娠进行回顾性队列研究。 结果: 6943 例异位妊娠中 79 例 (1.14%) 为 OP。随着时间的推移,辅助生殖技术后 OP 的患病率呈上升趋势,从 8.33% 上升到 15.22%。既往腹部手术史是 OP 的危险因素之一 (OR 0.41,95% CI 0.18 ~ 0.95,p = 0.04)。只有 2 例 (2.53%) 患者超声诊断为 OP 符合其出院诊断。但超声检查可清晰发现 56 例 (80.0%) 盆腔积血形成无回声区。OP 患者与输卵管妊娠患者血清 β-hCG 水平差异有统计学意义 (2762.73 ± 1915.24 mmol/L vs 1034.20 ± 915.32 mmol/L,P <0.001)。 结论: 辅助生殖技术后 OP 的患病率呈上升趋势。腹部手术史可能是具有高 β-hCG 水平倾向的 OP 患者的高危因素。术前超声诊断虽然准确率低,但有助于 OP 的早期诊断。

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作者列表:["Bilibio JP","Belém Gama T","Nascimento I","José Conceição Meireles A","Aguiar A","do Nascimento FC","Lorenzzoni PL"]

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影响因子:2.02
发表时间:2020-01-19
DOI:10.1111/1471-0528.16102
作者列表:["Belloeil V","Tessier Cazeneuve C","Leclercq A","Mercier MB","Legendre G","Corroenne R"]

METHODS:OBJECTIVES:To evaluate the impact of pre-operative Music Therapy (MT) on pain in first-trimester abortion under local anaesthesia (ALA). DESIGN:Randomised controlled trial comparing patients undergoing a first-trimester ALA with or without a pre-operative MT session. SETTING:University hospital of Angers from November 2016 to August 2017. POPULATION:Patients who underwent first-trimester abortion under ALA. METHODS:Patients allocated to MT group underwent a pre-operative 20 minutes session of MT. MAIN OUTCOME MEASURES:Pain was assessed using a visual analogue scale (VAS) just before the procedure, during the procedure, at the end of the procedure and upon returning to the ward. RESULTS:159 patients were randomised (80 in MT group, and 79 in the control group). 2 patients were excluded from the control group and 6 from the MT group. Therefore, 77 patients were analysed in the control group and 74 in the MT group. The intensity of pain were similar in both the MT group and the Control group just before the procedure (VAS: 4.0±2.9 vs. 3.6±2.5, p=0.78), during the procedure (VAS: 5.3±2.5 vs. 4.9±2.9, p=0.78), at the end of the procedure (VAS: 2.7±2.4 vs. 2.6±2.4, p=0.43) and upon returning to the ward (VAS:1.8±2.0 vs. 1.5±2.0, p=0.84). The difference in pain between entering the department and returning to the room after the procedure was similar between the MT and Control groups (0.3±2.5 vs. 0.3±2.4 VAS levels difference; p=0.92). CONCLUSION:Music therapy session before an ALA procedure resulted in no improvement in patient perception of pain during a first-trimester abortion.

关键词: 流产 焦虑 音乐 疼痛
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