摘要
目的 探讨体外受精 -胚胎移植 (IVF -ET)后宫内外同时妊娠 (HP)的发生率、危险因素、诊断及防治方法。方法 对IVF -ET后发生宫内外同时妊娠 6例病例进行回顾性分析。结果 宫内外同时妊娠的发生率为 0 95 %。 6例病人均移植 3个以上胚胎 ,4例有盆腔或输卵管疾病史 ;宫内外同时妊娠症状以腹痛为主 ,2例伴腹肌紧张及低血容量休克 ,3例有阴道流血。 6例病人中 2例经B超确诊 ,3例经手术确诊 ,1例误诊为阑尾炎。1例行输卵管修补术 ,余行输卵管切除术治疗 ,其中 2例自然分娩活婴。结论 IVF -ET后HP发生率明显增加 ,特别是有盆腔、输卵管疾病史或移植多个胚胎者。加强B超监测 ,有助于在妊娠部位破裂前发现、诊断及治疗HP ,防止不良后果发生。
Objective\ To investigate the incidence,risk factors and clinical characteristics and treatment methods of heterotopic pregnancy(HP)after IVF-ET.Methods\ We retrospectively analysed the clinical data of 6 patients with HP after IVF-ET.Results\ The rate of HP was 0 95%.All patients were transferred more than 3 embryoes.4 patients had history of tubal or pelvic disease.Abdominal pain was the most frequent symptom,and hypovolumic shock along with abdominal tenderness occurred in 2 cases.Approximately half of the patients did not complain of vaginal bleeding.2 of them were diagnosed by transvaginal ultrasonography detection.3 patients without adnexal mass were diagnosed in the surgical procedure.1 patient was misdiagnosed as appendicitis.Salpingectomy was the most common treatment used for removal of the EP,2 patients of the complicated gestation produced live children.Conclusion\ IVF-ET appears to predispose to HP,particularly after tubal or pelvic diseases and multiple embryoes transfer.Transvaginal ultrasonography is the most sensitive method for diagnosis.But the diagnosis is so difficult that all cases are diagnosed only after rupture.Close monitoring by B-ultrasound in the early weeks of pregnancy in assisted reproduction patient is important so that we can prevent the deleterious effects of delayed treatment of HP.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2001年第1期32-34,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
宫内外同时妊娠
妊娠结局
助孕技术
体外受精
胚胎移植
Heterotopic pregnancy\ Pregnancy outcome\ Assisted reproduction technology\ In vitro,fertilization\ Embryo transfer
