This study examined the misdiagnosis and delayed diagnosis factors for ectopic pregnancy（EP） and heterotopic pregnancy（HP） after in vitro fertilization and embryo transfer（IVF-ET） in an attempt to reduce the dia...This study examined the misdiagnosis and delayed diagnosis factors for ectopic pregnancy（EP） and heterotopic pregnancy（HP） after in vitro fertilization and embryo transfer（IVF-ET） in an attempt to reduce the diagnostic error. Clinical data of patients who underwent IVF-ET treatment and had clinical pregnancy from 12463 cycles were retrospectively analyzed. Their findings of serum β-hCG test and transvaginal ultrasonography were also obtained during follow-up. These patients were divided into two groups according to the diagnosis accuracy of EP/HP： early diagnosis and misdiagnosis/delayed diagnosis. The results showed that the incidence of EP and HP was 3.8%（125/3286） and 0.8%（27/3286） respectively for IVF/ICSI-ET cycle, and 3.8%（55/1431） and 0.7%（10/1431） respectively for frozen-thawed embryo transfer（FET） cycle. Ruptured EP occurred in 28 patients due to initial misdiagnosis or delayed diagnosis. Related factors fell in 3 categories：（1） clinician factors： misunderstanding of patients＇ medical history, insufficient training in ultrasonography and unawareness of EP and HP;（2） patient factors： noncompliance with medical orders and lack of communication with clinicians;（3） complicated conditions of EP： atypical symptoms, delayed elevation of serum β-hCG level, early rupture of cornual EP, asymptomatic in early gestation and pregnancy of unknown location. All the factors were interwoven, contributing to the occurrence of EP and HP. It was concluded that complicated conditions are more likely to affect the diagnosis accuracy of EP/HP after IVF-ET. Transvaginal ultrasonography should be performed at 5 weeks of gestation. Intensive follow-up including repeated ultrasonography and serial serum β-hCG tests should be performed in patients with a suspicious diagnosis at admission.展开更多
目的综合分析经腹部超声与经阴道彩色多普勒超声(transvaginal color doppler ultrasound)早期诊断宫外孕的效果。方法选取我院2015年6月至2016年8月收治的宫外孕患者102例作为研究对象,按照入院顺序随机分为试验组与对照组,每组均为51...目的综合分析经腹部超声与经阴道彩色多普勒超声(transvaginal color doppler ultrasound)早期诊断宫外孕的效果。方法选取我院2015年6月至2016年8月收治的宫外孕患者102例作为研究对象,按照入院顺序随机分为试验组与对照组,每组均为51例。对照组应用经腹部超声诊断方法,试验组应用经阴道彩色多普勒超声诊断方法。分析两组患者的破裂型宫外孕、未破裂型宫外孕、附件区包块、宫内假孕囊、卵黄囊、胚芽等检出率。结果试验组患者的破裂型宫外孕、未破裂型宫外孕检出率分别为88.24%、82.35%,对照组患者的破裂型宫外孕、未破裂型宫外孕检出率分别为39.22%、43.14%,试验组患者的破裂型宫外孕、未破裂型宫外孕检出率远远高于对照组(P<0.05);试验组患者附件区包块、宫内假孕囊、卵黄囊、胚芽等检出率远远高于对照组(P<0.05)。结论经阴道彩色多普勒超声诊断早期宫外孕患者的效果远远优于经腹部超声诊断。展开更多
基金supported by the National Natural Science Foundation of China(No.81170574)the National Key Basic Research Development Plan of China(973 Program)(No.2007CB948104)+1 种基金Key Science and Technology Projects of Guangzhou(No.11C22120737)Comprehensive Strategic Sciences Cooperation Projects of Guangdong Province and Chinese Academy(No.04020416)
文摘This study examined the misdiagnosis and delayed diagnosis factors for ectopic pregnancy（EP） and heterotopic pregnancy（HP） after in vitro fertilization and embryo transfer（IVF-ET） in an attempt to reduce the diagnostic error. Clinical data of patients who underwent IVF-ET treatment and had clinical pregnancy from 12463 cycles were retrospectively analyzed. Their findings of serum β-hCG test and transvaginal ultrasonography were also obtained during follow-up. These patients were divided into two groups according to the diagnosis accuracy of EP/HP： early diagnosis and misdiagnosis/delayed diagnosis. The results showed that the incidence of EP and HP was 3.8%（125/3286） and 0.8%（27/3286） respectively for IVF/ICSI-ET cycle, and 3.8%（55/1431） and 0.7%（10/1431） respectively for frozen-thawed embryo transfer（FET） cycle. Ruptured EP occurred in 28 patients due to initial misdiagnosis or delayed diagnosis. Related factors fell in 3 categories：（1） clinician factors： misunderstanding of patients＇ medical history, insufficient training in ultrasonography and unawareness of EP and HP;（2） patient factors： noncompliance with medical orders and lack of communication with clinicians;（3） complicated conditions of EP： atypical symptoms, delayed elevation of serum β-hCG level, early rupture of cornual EP, asymptomatic in early gestation and pregnancy of unknown location. All the factors were interwoven, contributing to the occurrence of EP and HP. It was concluded that complicated conditions are more likely to affect the diagnosis accuracy of EP/HP after IVF-ET. Transvaginal ultrasonography should be performed at 5 weeks of gestation. Intensive follow-up including repeated ultrasonography and serial serum β-hCG tests should be performed in patients with a suspicious diagnosis at admission.
文摘目的综合分析经腹部超声与经阴道彩色多普勒超声(transvaginal color doppler ultrasound)早期诊断宫外孕的效果。方法选取我院2015年6月至2016年8月收治的宫外孕患者102例作为研究对象,按照入院顺序随机分为试验组与对照组,每组均为51例。对照组应用经腹部超声诊断方法,试验组应用经阴道彩色多普勒超声诊断方法。分析两组患者的破裂型宫外孕、未破裂型宫外孕、附件区包块、宫内假孕囊、卵黄囊、胚芽等检出率。结果试验组患者的破裂型宫外孕、未破裂型宫外孕检出率分别为88.24%、82.35%,对照组患者的破裂型宫外孕、未破裂型宫外孕检出率分别为39.22%、43.14%,试验组患者的破裂型宫外孕、未破裂型宫外孕检出率远远高于对照组(P<0.05);试验组患者附件区包块、宫内假孕囊、卵黄囊、胚芽等检出率远远高于对照组(P<0.05)。结论经阴道彩色多普勒超声诊断早期宫外孕患者的效果远远优于经腹部超声诊断。
