IVF-ET后宫内外同时妊娠不典型病例报告并文献复习  

The atypical case report and literature review of heterotopic pregnancy after IVF- ET

作　　者：曹景云[1] 李爱斌[1] 沈兰[1] 

机构地区：[1]武汉大学人民医院生殖中心,武汉430060

出　　处：《中国优生与遗传杂志》2014年第2期122-124,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)后宫内外妊娠的不典型临床表现及防治方法。方法对在武汉大学人民医院生殖科进行助孕治疗后发生宫内外同时妊娠的2例病例进行回顾性分析。结果典型的宫内外同时妊娠(heterotopic pregnancy,HP)的临床表现既具有宫内妊娠的特点又具有异位妊娠的特点,其四联征为:腹痛、腹部包块、腹膜刺激症状和子宫增大,但本文中的两例病例均无上述典型表现,其中一例因先兆流产收住入院;另一例因卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)收住入院,两例均经腹腔镜探查确诊与治疗,治疗后宫内妊娠存活。结论 IVF-ET带来的并发症较多,其中宫内外妊娠后果较为严重,尤其是症状不典型的宫内外同时妊娠患者易误诊从而导致严重后果,因此应加大对IVF-ET后妊娠患者宫内及附件等盆腔器官的监测,以便对疾病可以早发现、早诊断、早治疗,防治不良结果的发生。Objective： To investigate the atypically clinical manifestations and prevention methods of heterotopic pregnancy after IVF - ET. Methods： Retrospectively analyzing two cases of heterotopic pregnancy after assisted reproductive treatment in People＇s Hospital of Wuhan University reproductive departments. Results ： Typical clinical performances of heterotopic pregnancy both have the characteristics of ectopic pregnancy and intrauterine pregnancy, there exist quadruple signs： abdominal pain, abdominal mass, perito- neal irritation and hysterauxesis, but there were no the typical performances above mentioned in two cases of this article that one case admitted to hospital because of threatened abortion and the other admitted to hospital due to ovarian hyperstimulation syndrome （ ovarian hyperstimulation syndrome, OHSS）. Two cases were confirmed and treated by laparoscopy diagnosis, after treatment, intrauterine pregnancy survived. Conclusion： IVF - ET brings complications in which heterotopic pregnancy is more serious, especially with atypi- cal symptoms, it will be easy to misdiagnose leading to serious consequences, and therefore we should increase the monitoring dynamics of gravidas after IVF - ET in the aspects of the pelvic organs such as intrauterine and accessories so that the diseases can be early de- tected, diagnosed, treated and prevented the occurrence of adverse outcomes.

关 键 词：体外受精 胚胎移植 宫内外同时妊娠 

分 类 号：R714.2[医药卫生—妇产科学]