ksmaКубанский научный медицинский вестникKuban Scientific Medical Bulletin1608-62282541-9544Kuban State Medical University10.25207/1608-6228-2017-24-6-150-160ksma-940Research ArticleОБЗОРЫREVIEWЭКТОПИЧЕСКАЯ СТЕНОЧНАЯ БЕРЕМЕННОСТЬECTOPIC MURAL PREGNANCYМАКУХИНАТ. Б.MAKUKHINAT. B.soltatiana@mail.ruМАКУХИНАВ. В.MAKUKHINAV. V.soltatiana@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budget Educational Institution of Higher Education Kuban State Medical University of the Ministry of Healthcare of the Russian FederationRussian Federation20172512201706150160Copyright © МАКУХИНА Т.Б., МАКУХИНА В.В., 20172017МАКУХИНА Т.Б., МАКУХИНА В.В.MAKUKHINA T.B., MAKUKHINA V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ksma.elpub.ru/jour/article/view/940Цель

Цель. Систематизация и анализ опубликованных данных для уточнения терминологии, факторов риска, методов диагностики и лечебной тактики для внематочной (эктопической) стеночной беременности. Материалы и методы. Поиск информации, опубликованной в электронных библиографических базах данных PubMed и Cochrane Library, по ключевым словам. Ограничения: английский язык, период до 31 октября 2017 года включительно. Для анализа отбирались работы, содержащие информацию о факторах риска, методах и критериях диагностики, сведения о методах лечения, либо проспективного наблюдения с эктопической стеночной беременностью. Работы распределялись по категориям: клинический случай/серия случаев, обзор, клиническое исследование, рандомизированное контролируемое исследование, систематический обзор/мета-анализ; выделялись абстракты и полноразмерные статьи. Результаты. Обнаружено 1425 источников, соответствующих ключевым словам. Из включенных согласно критериям 1006 работ 236 представлены статьями и 770 – абстрактами; в том числе 863 клинических случаев, 129 обзоров, 5 клинических исследований, 4 рандомизированных контролируемых исследования, 5 систематических обзоров. Эктопическая стеночная беременность включает различные формы со специфическими факторами риска, в ряде случаев возможно донашивание беременности до срока жизнеспособности плода. Основным методом диагностики является ультразвуковое исследование. Сроки диагностики и методы лечения не стандартизированы. Заключение. Ввиду редкости патологии и высокого риска серьезных осложнений, включая утрату фертильности и смерть, необходим национальный аудит стеночных эктопических беременностей с формированием базы данных для анализа исходов и расчета индивидуального прогноза. Для повышения информированности врачей о редких формах эктопической беременности и совершенствования стандартов оказания медицинской помощи необходима разработка клинических рекомендаций.

 

 

Aim

Aim. Systemization and analysis of published data to define terminology, risk factors, diagnostic methods and treatment strategy for ectopic mural pregnancy. Materials and methods. Keyword search of information published on electronic bibliographic databases PubMed and Cochrane Library. Limitations: English language, period till October 31, 2017 inclusive. For analysis we curated studies containing information about risk factors, diagnostic methods and criteria and treatment methods or prospective observation of ectopic mural pregnancy. The studies were divided in following categories: case report, review, clinical trial, randomized clinical investigation, systematic reviews and meta-analyses; abstracts and articles were calculated separately. Results. We found 1425 sources corresponding to the keywords. Among 1006 studies included in the review according to inclusion criteria there were 236 articles and 770 abstracts of which there were 863 case reports, 129 reviews, 5 clinical trials, 4 randomized clinical investigations, 5 systematic reviews. Ectopic mural pregnancy includes different forms with specific risk factors; in some cases pregnancy prolongation till fetus livability is possible. The main diagnostic method is ultrasound. Diagnostic terms and treatment methods are not standardized. Conclusion. Due to the rarity of this pathology and high risk of dangerous complications including fertility loss and lethal outcomes there is a need for a national audit of mural ectopic pregnancies with a database establishment for possible outcomes analysis and an individual prognosis assessment. It is necessary to develop clinical guidelines to raise the level of doctors’ awareness about the rare forms of ectopic pregnancies and improve standards of medical treatments.

 

 

cтеночная эктопическая беременностьинтрамуральная эктопическая беременностьинтерстициальная эктопическая беременностьэктопическая беременность в трубном углушеечно-перешеечная беременностьбеременность в рубце после кесарева сеченияmural ectopic pregnancyintramural ectopic pregnancyinterstitial ectopic pregnancycesarean (caesarean) scar pregnancyisthmico-cervical ectopic pregnancycervico-isthmic ectopic pregnancyangular ectopic pregnancyReferencesShen L, Fu J, Huang W, Zhu H, Wang Q, Yang S, Wu Tet_al2014-Interventions for non-tubal ectopic pregnancies (Protocol). Cochrane Database of Systematic Reviews. 2014, Issue 7. Art. No.: CD011174. DOI: 10.1002/14651858.CD011174.Shen L, Fu J, Huang W, Zhu H, Wang Q, Yang S, Wu Tet_al2014-Interventions for non-tubal ectopic pregnancies (Protocol). Cochrane Database of Systematic Reviews. 2014, Issue 7. Art. No.: CD011174. DOI: 10.1002/14651858.CD011174.Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. 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The authors declare that there are no conflicts of interest present.