体外受-精胚胎移植后宫内宫外同时妊娠9例临床分析  

Clinical analysis of 9 cases of heterotopy pregnancy after in vitro Fertilization and embryo transfer

作　　者：徐望明[1] 杨菁[1] 龙文[1] 苏红[1] 程丹[1] 

机构地区：[1]武汉大学人民医院生殖医学中心,430060

出　　处：《中国妇幼保健》2005年第3期369-370,共2页Maternal and Child Health Care of China

摘　　要：目的 :分析体外受精 胚胎移植 (IVF ET)后 ,宫内宫外同时妊娠 (HP)的发病率、好发因素、诊断和处理方法。方法 :回顾性分析 9例IVF ET后HP病例。结果 :IVF ET妊娠 2 98例中 ,发生HP 9例 ,发生率为 3 0 2 %。8例有明显的输卵管或盆腔疾患史 ,其中 3例有宫外孕史 ,3例有输卵管手术史。 9例患者均于明确诊断后立即行腹腔镜下输卵管切除术 ,7例为输卵管未破裂HP ,术后宫内妊娠继续 ;2例输卵管破裂HP患者术后 1周内宫内妊娠自然流产。结论 :既往输卵管或盆腔疾患、宫外孕、输卵管手术是IVF ET后HP发生的常见原因 ;超声检查结合HCG值测定是最有效的诊断方法 ,早期诊断、早期治疗可明显改善预后 ;腹腔镜下输卵管切除术是治疗HP的最好方法。Objective:To analyse the prevalence rate,factor;diagnosis and treatment of heterotopy pregnancy(HP) after in vitro fertilization and embryo transfer(IVF-ET) Methods:9 patients with HP after IVF-ET were retrospectively studied. Results:Of 298 pregnant women after IVF-ET. 9 had an HP. The occurred rate was 3.02%. Eight patients had history of tubal or pelvic disease, three had previous EP and three had previous pelvic Surgery. Seven cases were diagnosis before rupture of tubal pregnancy and performed Salpingectomy, the intrauterine gestation was preserved. Other two cases, which were diagnosis after rupture of tubal pregnancy appeared abortion after Salpingectomy. Conclusion:Previous tubal or pelvic disease, EP and tubal surgery are risk factors for HP. The combination of sonograph and serum HCG measurement is reliable in the diagnosis of EP. Laparoscopic salpingectomy is still considered to be the best method for the treatment of HP.

关 键 词：宫内宫外同时妊娠(HP) 体外受精-胚胎移植(IVF-ET) 诊断 治疗 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]