早期宫角妊娠的临床转归与治疗  

Clinical outcomes and treatment of early stage of corneal heterotopic pregnancy

作　　者：王雅琴[1,2] 赵庆红 徐望明[1,2] 杨菁[1,2] Wang Yaqin;Zhao Qinghong;Xu Wangming;Yang Jing(Reproductive Medical Center,Renmin Hospital,Department of Ultrasound,Wuhan University,Wuhan 430060,Chin;Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院生殖医学中心,430060 [2]湖北省辅助生殖与胚胎发育医学临床研究中心,武汉430060 [3]武汉大学人民医院妇产科超声中心,430060

出　　处：《中华生殖与避孕杂志》2018年第7期583-587,共5页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨早期宫角妊娠的临床转归及治疗。方法回顾性分析了近6年在本院行促排卵或宫腔内人工受精/体外受精-胚胎移植(IUI/IVF-ET)助孕的16例孕早期超声诊断为宫角妊娠患者的临床资料。结果 16例无症状型早期宫角妊娠患者均动态超声观察及严密随访,其中5例孕囊转为宫内妊娠;8例孕囊继续向宫角肌层扩展者中7例行手术终止妊娠,1例行经阴道宫角妊娠减胎术;2例孕囊位置无明显改变者行宫角妊娠减胎术;1例胚胎停育者行药物杀胚加清宫术。结论早期宫角妊娠具有生长方向的双向性,对于无明显临床症状且有强烈生育要求的妇女,超声早期诊断和孕8周内的严密动态监测可作为帮助选择继续期待观察或终止妊娠的重要依据。Objective To explore the clinical outcomes and treatment of early stage of corneal heterotopic pregnancy for desired fertility women. Methods The clinical data were analyzed in 16 cases with early stage of cornual pregnancy diagnosed by ultrasound who underwent stimulate ovulation, intrauterine insemination （IUI）, in vitro fertilization （IVF）-embryo transfer （ET） in our hospital. Results Sixteen cases of asymptomatic patient with early stage of comual pregnancy opted for expectant treatment by close ultrasound monitoring. Eight cases gestation sac expanded to the horn of uterus, 2 cases remained in original site, 5 cases shifted to cavity and 1 case occurred spontaneous abortion. Seven cases of expanded to horn of uterus were offered with surgery while 3 cases were successfully treated by transvaginal ultrasound guided selective embryo reduction, 1 case of spontaneous abortion was successfully treated by methotrexate and mifepristone with curettage. Conclusion It＇s possible that cornual pregnancy turns into uterine pregnancy, therefore early ultrasonographic diagnosis and close ultrasonographic and clinical monitoring within 8 weeks of pregnancy maybe provide important principles of treatments of specific measures which include observation and interruption of pregnancy for desired fertility patients with early stage of cornual pregnancy.

关 键 词：宫角妊娠 生育需求 超声 诊断 监测 处理 

分 类 号：R714.22[医药卫生—妇产科学]