体外受精-胚胎移植后妊娠早期宫腔积血的影响因素分析  

Evaluation of related factors associated with first-trimester intrauterine hematoma in the IVF-pregnancies

作　　者：项兰[1] 张焕焕[1] 魏兆莲[1] 何晔[1] 王娅[1] 

机构地区：[1]安徽医科大学第一附属医院妇产科,合肥市230022

出　　处：《中华全科医学》2015年第6期959-960,978,共3页Chinese Journal of General Practice

基　　金："十二五"国家科技支撑计划项目(2012BAI32B01)

摘　　要：目的文献报道妊娠早期宫腔积血的出现与异常妊娠结局关系密切,而经体外受精-胚胎移植（IVF-ET）助孕后宫腔积血的发生率显著高于自然妊娠,因此,本研究探讨经IVF-ET助孕后妊娠早期影响宫腔积血发生的相关因素,以了解IVF-ET异常妊娠结局的高危因素。方法回顾性分析IVF-ET助孕后获得宫内妊娠且合并宫腔积血患者274例的临床资料,研究不同不孕原因（输卵管因素、多囊卵巢综合症、内异症及男方因素）、妊娠年龄（20-25岁、26-30岁、31-35岁及≥36岁）、周期类型（新鲜及解冻周期）、孕囊个数（1个,2个,3-4个）对宫腔积血发生率的影响。对各组间数据的比较采用χ2检验。结果不同不孕原因、妊娠年龄及周期类型组间宫腔积血发生率的差异均不具有统计学意义（P〉0.05）。宫腔积血在不同孕囊数组间发生率的差异具有统计学意义（P〈0.05）,各组发生宫腔积血的比例如下：1个孕囊数组10.5%,2个孕囊数组14.3%,3-4个孕囊数组22.6%,3组之间两两比较差异均具有统计学意义（P〈0.02）。结论 IVF-ET助孕后妊娠早期宫腔积血的发生与移植后孕囊个数有关,孕囊个数越多,发生宫腔积血的风险越高。不同不孕原因、妊娠年龄及周期类型对早期宫腔积血的发生影响作用不大。提示多胚胎移植可能是IVF-ET异常妊娠结局的高危因素。Objective It has been reported that intrauterine hematoma（IUH） in the early pregnancies was closely associ- ated with adverse pregnancy outcome. The incidence of IUH in the pregnancies achieved by in vitro fertilization-embryo transfer（IVF-ET） was significantly higher than that of spontaneous pregnancies. Therefore,the aim of this study is to in- vestigate the related factors associated with first-trimester IUH and explore the risk factors for adverse pregnancy outcome in IVF-pregnancies. Methods Total of 274 intrauterine pregnancies with first-trimester hematomas, conceived by IVF- ET, were studied retrospectively. The impact of different reasons for infertility （ such as tubal infertility, polycystic ovarian syndrome, endometriosis and male infertility）, maternal age （ 20 - 25 y, 26 - 30 y, 31 - 35 y and 1〉 36 y ）, therapeutic schedules（ fresh and frozen thawed embryo transfer） and number of fetuses （ one, two, three to four） on the presence of IUH was analyzed. The variables between groups were analyzed by X2 test. Results No significant differences for the in- cidence of first-trimester IUH were observed in the different groups of reasons for infertility, maternal age and therapeutic schedules （ P 〉 0.05 ）. The difference in the number of fetuses did reach a statistical significance （ P 〈 0.05 ）, with 10.5 % of one fetus, 14.3 % of two fetuses,22.6% of three to four fetuses. Moreover, differences between any two groups showed statistical significance respectively （ P 〈0. 02）. Conclusion The number of fetuses does make a great difference to the presence of the first-trimester IUH in the IVF-pregnancies. The more embryos we transfer, the higher the risk of IUH presents. However,the presence of IUH may not closely relate to the reasons for infertility, maternal age and therapeutic schedules. Multi-embryos transfer will be a risky factor for pregnancy complications in IVF-pregnancies.

关 键 词：宫腔积血 病因 体外受精-胚胎移植 

分 类 号：R714.2[医药卫生—妇产科学] R715[医药卫生—临床医学]