异位妊娠的诊断和管理.pdfVIP

Diagnosis and Management of Ectopic Pregnancy Green-top Guideline No. 21 RCOG/AEPU Joint Guideline | November 2016 Please cite this paper as: Elson CJ, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ on behalf of the Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy. BJOG 2016; DOI: 10.1111/1471- 0528.14189. DOI: 10.1111/1471-0528.14189 Diagnosis and Management of Ectopic Pregnancy This guideline replaces The Management of Tubal Pregnancy, which was published in 2004. Executive summary of recommendations Diagnosis of ectopic pregnancy How is a tubal pregnancy diagnosed? What are the ultrasound criteria? Transvaginal ultrasound is the diagnostic tool of choice for tubal ectopic pregnancy. [New 2016] B Tubal ectopic pregnancies should be positively identified, if possible, by visualising an adnexal D mass that moves separate to the ovary. [New 2016] What biochemical investigations should be carried out? A serum progesterone level is not useful in predicting ectopic pregnancy. [New 2016] B A serum beta-human chorionic gonadotrophin (b-hCG) level is useful for planning the C management of an ultrasound visualised ectopic pregnancy. [New 2016] How is a cervical pregnancy diagnosed? What are the ultrasound criteria? The following ultrasound criteria may be used for the diagnosis of cervical ectopic pregnancy: D an empty uterus, a barrel-shaped cervix, a gestational sac pres