体外受精-胚胎移植术后宫内外复合妊娠临床分析  

Heterotopic pregnancy after in vitro fertilization and embryo transfer: risk factors and pregnancy outcomes

作　　者：徐芝慧[1] 潘承双[1] 

机构地区：[1]温州医科大学附属第一医院生殖医学中心,325000

出　　处：《浙江医学》2017年第24期2222-2224,2235,共4页Zhejiang Medical Journal

摘　　要：目的探讨体外受精/单精子卵胞浆内注射-胚胎移植术(IVF/ICSI-ET)后发生宫内外复合妊娠(HP)的高危因素及妊娠结局。方法回顾性选取接受IVF/ICSI-ET后发生HP的患者54例(HP组),选取同期接受IVF/ICSI-ET后发生宫内双胎妊娠的患者119例作为对照组。分析发生HP的高危因素,比较两组患者的妊娠结局。结果 HP组患者既往流产次数、异位妊娠次数及输卵管性不孕率均高于对照组(均P<0.05)。HP组患者确认妊娠日血清β-h CG水平低于对照组(P<0.05),流产率高于对照组(P<0.05),早产率低于对照组(P<0.05)。而足月妊娠率、继续妊娠率两组间比较均无统计学差异(均P>0.05)。结论既往多次流产、异位妊娠及输卵管病变为HP的高危因素。HP一旦确诊,积极治疗可使宫内妊娠获得良好结局。Objective To investigate the risk factors and pregnancy outcomes of heterotopic pregnancy after in vitrofertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI- ET). Methods Fifty- four women with heterotopicpregnancy (HP group) and 119 women with intrauterine twin pregnancy (control group) after receiving IVF/ICSI- ET at ourreproductive medicine center between January 2009 and July 2016 were enrolled in the study. The risk factors of heterotopicpregnancy were analyzed and the pregnant outcomes were compared between two groups. Results The frequency of previousabortion and ectopic pregnancy, the percent of tubal infertility in HP group were higher than those in control group (P<0.05).Compared to control group, the mean level of serum β- hCG (16 days after ovum retrieval) was lower (P<0.05), the miscarriagerate was higher and preterm birth rate was lower (P<0.05) in HP group . However, there were no significant differences interm pregnancy rate and continuing pregnancy rate between two groups (P>0.05). Conclusion Repeated abortion, ectopicpregnancy and fallopian tubal disease are the risk factors of heterotopic pregnancy after IVF- ET. The ultrasound scan issuggested for suspected heterotopic pregnant women, and once the HP was diagnosed a prompt treatment may result in adesirable outcome of the intrauterine pregnancy.

关 键 词：体外受精 胚胎移植 宫内外复合妊娠 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]