体外受精-胚胎移植后异位妊娠相关危险因素的研究  

Research on the Relative Risk Factors of Ectopic Pregnancy After IVF-ET

作　　者：杜爱军[1] 张印峰[1] 张云山[1] 罗海宁[1] 徐凤琴[1] 

机构地区：[1]天津市中心妇产科医院,300100

出　　处：《国际生殖健康／计划生育杂志》2012年第2期97-98,104,共3页Journal of International Reproductive Health/Family Planning

摘　　要：目的:探讨取卵周期体外受精-胚胎移植(IVF-ET)后异位妊娠(EP)的危险因素。方法:选择2005年1月—2010年12月行IVF-ET治疗后EP患者122例(占同期行IVF-ET治疗1 850例患者的6.6%),其中包括宫内外同时妊娠(HP)患者11例,为观察组;在同期IVF-ET后获宫内临床妊娠1 728例患者中随机抽取450例为对照组。比较2组间盆腔输卵管病变、子宫内膜异位症(EMs)及EMs术后、卵巢病变、月经稀发所占比例及一般临床特征的区别。结果:多因素Logistic回归分析结果表明,盆腔输卵管病变(β=0.705,OR=2.023)、EMs及EMs术后(β=1.393,OR=4.025)、内膜(En)厚度≤7 mm(β=1.695,OR=5.446)是IVF-ET中异位妊娠发生的危险因素。结论:对具有以上危险因素的EP患者,在行IVF-ET治疗前尽量减少危险因素的存在,如存在盆腔输卵管因素可以对部分患者进行输卵管近端结扎或者切除;在患者妊娠后,为防止异位妊娠灶破裂,应根据血清人绒毛膜促性腺激素(hCG)值适当提前行阴道超声检测的时间(IVF-ET后一般进行阴道超声检测的时间为胚胎移植后28 d)和适当增加前期超声检测的次数,及时做到早发现、早预防、早治疗尤为重要。Objective：To explore the risk factors of ectopic pregnancy after in vitro fertihzation and embryo transfer （IVF-ET）. Methods： 122 cases of ectopic pregnancy in 1 850 cases after IVF-ET treatment （6.6%）were selected between 2005, Jan. and 2010, Dec. in Center of Reproductive Medicine,Tianjin Central Hospital of Gynecology and Obstetrics,including 11 cases of Heterotopic pregnancy, as the observation group. 450 cases were randomly selected from 1 728 cases of intrauterine pregnancy after IVF-ET as control. Pelvic oviduct factors,endometriosis and endometriosis postsurgery factors,ovary diseases,hypomenorrhea, general clinical features were compared between two groups. Results：The ectopic pregnancy rate was significantly increased in those patients with pelvic oviduct factors,endometriosis and endometriosis postsurgery factors, endometrial thickness ≤7 mm. Conclusions：For those patients who have above mentioned risk factors,those risk factors should be controlled to the greatest extent when they received IVF-ET treatment. For those patients who have potential EP, early discovery and diagnosis such as sera hCG level tests and B ultrasounds at reasonable times, and early treatment, are important for them to prevent ectopic pregnancy rupture.

关 键 词：受精 体外 胚胎移植 妊娠 异位 危险因素 妊娠并发症 

分 类 号：R714.8[医药卫生—妇产科学]