体外受精-胚胎移植术后宫内宫外同时妊娠15例临床分析  

Heterotopic pregnancy after in vitro fertilization and embryo transfer:a clinical analysis of 15 cases

作　　者：靳镭[1] 朱桂金[1] 章汉旺[1] 李豫峰[1] 印贤琴[1] 刘玉芹[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院生殖中心,湖北武汉430030

出　　处：《生殖医学杂志》2008年第1期28-30,共3页Journal of Reproductive Medicine

摘　　要：目的探讨体外受精-胚胎移植(IVF-ET)后宫内宫外同时妊娠的发病率、危险因素、早期诊断及最佳治疗方式。方法对2001年10月至2006年10月在我院生殖中心行IVF-ET后获宫内宫外同时妊娠(HP)15例进行回顾性分析。结果同期IVF-ET后临床妊娠1,230例,HP15例,发生率1.2%。15例均为输卵管因素不育,其中1例合并男性因素;7例有盆腔手术史,3例宫外孕史;14例为宫内合并输卵管妊娠,1例为双侧输卵管切除术后合并间质部妊娠。15例患者均于确诊后手术治疗,其中10例在异位妊娠破裂前确诊,5例于破裂后确诊。术后9例宫内妊娠继续至足月分娩,4例胚胎停止发育,2例继续妊娠。结论输卵管病变或(和)盆腔手术史是IVF-ET术后HP发生的主要危险因素。IVF术前术中适当处理、早期诊断、及时治疗异位妊娠,有助于挽救宫内妊娠。Objective： To investigate the incidence, high risk factors, clinical characteristics and treatment methods of heterotopic pregnancy （HP） after in vitro fertilization and embryo transfer （IVF-ET）. Method： Fifteen cases of HP after IVF-ET were analyzed retrospectively. Results： There were 15 cases with HP out of 1,230 clinical pregnant women after IVF-ET, and the occurrence rate was 1.2%. All 15 patients had the IVF-ET treatment due to the tubal problems. 7 of them had previous pelvic surgeries and 3 had a history of ectopic pregnancy. 14 were found to be intrauterine pregnancy complicated with tubal gestation and 1 with cornual gestation after bilateral salpingectomy. Operation was performed for all 15 cases, with the intrauterine gestation preserved in 11 cases and aborted after operation in other 4 cases. Conclusion： HPs increase with the development of assisted reproductive technology. Tubal diseases are the major high risk factors. Early diagnosis and prompt treatment can maintain the intrauterine pregnancy.

关 键 词：宫内宫外同时妊娠 体外受精-胚胎移植 危险因素 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]