Abstract：
Ectopic pregnancy (EP) is a pregnancy where the growing blastocyst implants outside the endometrial cavity. EP account approximately for 0.5-1% of all pregnancies, and extrauterine implant is the leading cause of woman mortality in the first trimester of gestation. Non-tubal pregnancies (NTP) account for less than 5% of all EP. NTP are accompanied by a 7-8 times higher risk of maternal mortality when compared to tubal pregnancies, and their treatment might sometimes be very challenging. Subserosal pregnancy (SP) has been defined as rare variant of intramural pregnancy, where a portion of the gestational sac was surrounded only by the serosa of the uterus. Whereas the treatment of the ectopic pregnancies is crucial for patients\' lives and for adequate fertility sparing and considering the need for surgical treatment in many cases, an early diagnosis is important; thus we believe it g might be useful to define some criteria to guide subserosal pregnancy identification, and to distinguish it from other types of non-tubal ectopic pregnancy. A systematic review on Pubmed, Scopus, Web of Science and Google Scholar was performed. Case reports, randomized controlled trials, prospective controlled studies, prospective cohort studies, retrospective studies, and case series were considered eligible. In all databases mentioned were considered manuscripts published from 1990 up to March 2023. Only four articles were eligible for inclusion in this review. All patients underwent to surgical management in laparoscopy. The main risk factors for this type of ectopic pregnancy were previous uterine surgery with opening of the endometrial cavity and assisted reproductive techniques procedures. Considering our results, we propose new classification and diagnostic criteria for subserosal pregnancy, to distinguish it from other types of non-tubal ectopic pregnancies with the aim to preserve fertility following the most correct management.
摘要：
异位妊娠（EP）是生长的胚泡植入子宫内膜腔外的妊娠。EP约占所有怀孕的0.5-1％，子宫外植入物是妊娠早期妇女死亡的主要原因。非输卵管妊娠（NTP）占所有EP的不到5％。与输卵管妊娠相比，NTP伴随着7-8倍的孕产妇死亡风险。他们的治疗有时可能非常具有挑战性。浆膜下妊娠（SP）已被定义为壁内妊娠的罕见变体，其中妊娠囊的一部分仅被子宫浆膜包围。鉴于异位妊娠的治疗对于患者的生命和充分保留生育能力至关重要，并且考虑到在许多情况下需要手术治疗，早期诊断很重要;因此我们认为它可能是有用的，以确定一些标准，以指导浆膜下妊娠的鉴定，并将其与其他类型的非输卵管异位妊娠区分开来。对Pubmed的系统评价，Scopus,执行了WebofScience和GoogleScholar。病例报告,随机对照试验，前瞻性对照研究，前瞻性队列研究，回顾性研究,和病例系列被认为是合格的。在所有提到的数据库中，都被认为是1990年至2023年3月出版的手稿。只有四篇文章有资格纳入本评论。所有患者均接受腹腔镜手术治疗。这种类型的异位妊娠的主要危险因素是以前的子宫手术，子宫内膜腔开放和辅助生殖技术程序。考虑到我们的结果，我们提出了浆膜下妊娠的新分类和诊断标准，将其与其他类型的非输卵管异位妊娠区分开来，目的是在最正确的管理下保持生育能力。
