双侧输卵管绝育术后行体外受精-胚胎移植导致复合妊娠6例分析及文献复习  

Analysis of 6 cases of heterotopic pregnancy induced by in vitro fertilization-embryo transfer after bilateral tubal sterilization and literature review

作　　者：黄宝友[1] 赵红琴 金武敏 周凯[1] HUANG Bao-you;ZHAO Hong-qin;JIN Wu-min;ZHOU Kai(Department of Gynecology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院妇科,浙江温州325000 [2]温州医科大学附属第一医院生殖科,浙江温州325000

出　　处：《中国实用妇科与产科杂志》2018年第10期1139-1142,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨双侧输卵管绝育术后行体外受精-胚胎移植导致复合妊娠的类型、机制及临床诊治特点。方法回顾性分析及随访2006—2017年温州医科大学附属第一医院收治的6例双侧输卵管绝育术后行体外受精-胚胎移植导致复合妊娠患者的临床病例资料,并回顾国内外文献进行分析及总结。结果 6例患者平均年龄30.50岁(25~39岁),患者首次诊断均由超声发现,最早于胚胎移植术后25 d,最晚76 d发现。6例均行手术治疗,异位妊娠部位分别为宫角1例,输卵管壶腹部1例,输卵管峡部1例,输卵管间质部3例。术后胚胎发育停止行清宫术2例,剖宫产分娩活婴4例,随访至今均健康。结论双侧输卵管绝育术后仍有宫内外复合妊娠可能,孕早期常规行超声检查,早发现早治疗,治疗以手术为主,腹腔镜手术也是一种安全有效的处理方法。Objective To investigate the type,mechanism,clinical diagnosis and treatment of heterotopic pregnancy after in vitro fertilization-embryo transfer following bilateral fallopian tube sterilization.Methods Retrospectively analyze and follow up clinical case data of 6 patients with heterotopic pregnancy after in vitro fertilization-embryo transfer after bilateral tubal sterilization,who were admitted to the First Affiliated Hospital of Wenzhou Medical University from 2006 to 2017,and analyze the domestic and foreign literature.Results The average age of 6 patients was 30.50 years old（25-39 years old）.The initial diagnosis was confirmed by ultrasonography.The earliest was 25 days after the embryo transfer,the latest 76 days,and the mean was 37 days.All patients underwent surgical treatment.The site of ectopic pregnancy was cornual（1）,tubal ampulla（1）,tubal isthmus（1）and tubal interstitial（3）.Postoperative abortion was performed in 2 cases.Caesarean section was used to deliver 4 living babies and the follow-ups were healthy up to now.Conclusion There may still be intrauterine and extrauterine pregnancy after bilateral tubal sterilization.Ultrasound examinations should be performed early in the pregnancy for early detection and early treatment.Treatment is mainly by surgery and laparoscopic surgery is a safe and effective treatment.

关 键 词：输卵管绝育 体外受精-胚胎移植 复合妊娠 异位妊娠 

分 类 号：R714.22[医药卫生—妇产科学]