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Surgical and pathology data were analyzed with the quantitative serum hCG values from 131 patients with tubal pregnancies. The hCG value correlated with both the size and contents of the eccyesis. Patients with ruptured tubal pregnancies had significantly greater serum hCG levels than did those with intact tubal gestations. Isthmic tubal pregnancies were associated with more frequent rupture and larger amounts of hemoperitoneum than were pregnancies in the ampullary segment of the tube. Tubal rupture with hCG values below 100 mIU/mL occurred in two isthmic pregnancies but in no ampullary pregnancies. With serum hCG levels below 300 mIU/mL, significant hemorrhage did not occur unless the tube was ruptured. Half of the patients had hCG levels sufficient to use a vaginal sonographic hCG discriminatory zone to assist in the diagnosis. A maximum of 15% of tubal pregnancies may be diagnosed by ultrasonographic detection of adnexal cardiac activity. A serum hCG assay sensitive to 10 mIU/mL will detect nearly all tubal pregnancies. The hCG level frequently has diagnostic value when used in conjunction with vaginal sonography. At hCG levels of 100 mIU/mL or less, tubal rupture is very unlikely for ampullary, but not for isthmic, tubal pregnancies.
When an obstetrical patient was referred for inability to auscultate fetal heart tones at 18 weeks' gestation, ultrasound identified a single living fetus in the maternal right upper quadrant. Magnetic resonance imaging (MRI) ruled out a suspected uterine ectopic pregnancy and avoided laparotomy. The patient experienced an uncomplicated term delivery. MRI is a useful adjunct to ultrasound for mid-trimester pregnancy localization when the differential diagnosis includes uterine eccyesis.
Ectopic pregnancy is the most common form of pregnancy outside the uterus (eccyesis). During an ectopic pregnancy, the fertilised egg cell implants in the fallopian tube. This happens in around 1 % of all pregnancies. An ectopic pregnancy must be terminated as quickly as possible as severe complications could occur.
Heterotopic pregnancy is extremely difficult to diagnose. More than 50% of these pregnancies are identified by sonography or laparoscopy 2 weeks or more after the initial visualization of the intrauterine pregnancy,6 though approximately 85% go undiagnosed before the rupture of the eccyesis.
The assumption that detecting an intrauterine gestational sac by TVUS excludes eccyesis is based on the 50-year-old estimate of the prevalence of heterotopic pregnancy (1 in 30,000). In fact, TVUS has been quite useful in the early detection of heterotopic pregnancy. The sonographic finding of 1 gestational sac in the uterine cavity with another in the adnexum is diagnostic of this condition.
Approximately 90% of eccyesis accompanying intrauterine pregnancy occur in the fallopian tube, usually within its ampulla (FIGURE 1). It is perhaps easier to diagnose an ampullary pregnancy than an interstitial pregnancy, because there is a greater index of suspicion with a tube in place. However, an ampullary pregnancy also may be missed unless a heartbeat is detected in the adnexum.
Genital infection includes traditional sexual transmitted infection, bacterial vaginosis and candida vulvovaginitis, causing by Chlamydia trachomatis (Ct), Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), fungus or virus (Shuping et al., 2012; Xiaofang, 2007). Ct and Uu attract much attention with its frequent presence in genital infections. It is informed that Ct and Uu lead to genital infections of vagina, cervix and pelvic, and closely relate to infertility, eccyesis, abortion and IUGR (intrauterine growth retardation). Yunheng Zhou (Yunheng et al., 2010) took drug sensitivity tests on 1464 patients with genitourinary infections, and detected high relevance ratio of Ct and Uu . Besides, primary options of antibacterials in treating genitourinary infections would be tetracycline, minocycline and doxycycline. Jing Liu (Jing et al., 2014) found that Uu had been the major pathogenic bacteria for genital infections through the culture and drug test of Uu with 3127 women of reproductive age and patients with Uu infections were sensitive to minocycline doxycycline and biaxin, which could be the proof of clinical treatments. In addition, via the curative effects of treating minocycline and urealyticum-resistant genitourinary infections, Yongyong Zhou (Yongyao, 2010) confirmed that Chinese medicine combined with azithromycin was more effective in treating minocycline and Ureaplasma urealyticum infections than azithromycin or Chinese medicine alone. Based on above researches, this paper compares clinical curative effects of doxycycline and Chinese medicine combined with doxycycline in treating genital Ct and Uu infections, to make contribution to clinical treatments. 781b155fdc