宫内外复合妊娠中宫外妊娠的超声误诊分析及临床特征  

Clinical Features and Analysis of the Ultrasound Misdiagnosis of Extrauterine Pregnancy During Heterotopic Pregnancy

作　　者：周贇 黄勤 杨钰 叶宝英[1] Zhou Yun;Huang Qin;Yang Yu;Ye Baoying(Department of Ultrasound,The International Peace Maternity and Child Health Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai Key Laboratory of Embryo Original Diseases,Shanghai Municipal Key Clinical Specialty,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院超声科,上海市胚胎源性疾病重点实验室,上海市临床重点专科建设项目——"强主体"妇产科,上海市200030

出　　处：《中国超声医学杂志》2020年第7期632-635,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市科学技术委员会西医引导项目(No.16411963000)。

摘　　要：目的探讨HP宫外妊娠的超声误诊分析及临床特征。方法回顾性分析我院42例超声可疑HP患者,探讨HP宫外妊娠的超声误诊分析及临床特征。结果42例可疑HP患者,IVF-ET术后占80.95%,有腹痛、阴道流血、异位妊娠史、人流史、剖宫产史、妇科手术史、生育史和盆腔炎史的比例分别为50.00%、50.00%、23.80%、38.10%、23.80%、30.95%、23.80%和19.05%。包块类型50.00%为胎心胎囊型。71.43%有盆腔积液。30例首次超声检查即明确诊断(30/42,71.43%),2例超声检查未明确异位妊娠部位(2/42,4.76%),误诊3例(3/42,7.14%),延迟诊断7例(7/42,16.67%)。结论早孕期妇女停经后腹痛、阴道流血、IVF-ET术后、超声发现盆腔积液者需警惕HP可能。怀疑HP的患者,联合应用TAS与TVS检查可提高对HP的诊断率。Objective To discuss the clinical features and the ultrasound misdiagnosis of extrauterine pregnancy during heterotopic pregnancy.Methods 42 cases of heterotopic pregnancy suspected by ultrasound were analysed retrospectively to explore the clinical features and the ultrasound misdiagnosis of extrauterine pregnancy during heterotopic pregnancy.Results Among 42 cases of heterotopic pregnancy suspected by ultrasound,80.95%patients with HP following vitro fertilization and embryo transfer(IVF-ET).The rates of abdominal pain,vaginal bleeding,history of ectopic pregnancy,abortion,caesarean section,gynecologic surgery and pelvic inflammation were 50.00%,50.00%,23.80%,38.10%,23.80%,30.95%and 19.05%,respectively.50.00%of the ectopic masses were gestational sac with a yolk sac or fetal pole.71.43%has pelvic effusion.30 cases were clearly diagnosed after the first ultrasound examination(30/42,71.43%),the location of 2 cases were not clearly diagnosed by ultrasound examination(2/42,4.76%),3 cases were misdiagnosed(3/42,7.14%),and 7 cases were delayed(7/42,16.67%).Conclusions Early pregnancy women with abdominal pain after menopause,vaginal bleeding,IVF-ET,ultrasound found that pelvic effusion should be alert to HP.In patients who suspect HP,combined TAS and TVS can increase the diagnostic rate of HP.

关 键 词：宫内外复合妊娠 临床特征 超声误诊分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]