经阴道彩色多普勒超声诊断IVF-ET术后宫内外复合妊娠效果及腹腔镜手术后妊娠结局  

Effect of the transvaginal color Doppler ultrasonography for diagnosing the heterotopic pregnancy of patients after in vitro fertilization-embryo transfer and the pregnancy outcomes after laparoscopic surgery

作　　者：尚琴琴 刘何利 SHANG Qinqin;LIU Heli(Cangzhou Hospital of Integrative Medicine,Cangzhou,Hebei Province,061001)

机构地区：[1]河北省沧州市中西医结合医院,061001

出　　处：《中国计划生育学杂志》2024年第5期1117-1120,共4页Chinese Journal of Family Planning

基　　金：河北省医学科技研究计划项目(20220682)。

摘　　要：目的:探究经阴道彩色多普勒超声在体外受精-胚胎移植(IVF-ET)术后宫内外复合妊娠(HP)诊断应用及腹腔镜手术效果。方法:回顾性分析2020年3月-2022年12月本院生殖医学科接收的80例IVF-ET后HP患者临床资料,分析其超声诊断正确率、临床表现、超声声像图特征、腹腔镜手术及妊娠结局。结果:经阴道彩色多普勒超声诊断确诊71例,诊断正确率为88.8%,4例(5.0%)延迟诊断,5例(6.3%)误诊;异位妊娠67例(83.8%)位于子宫附件,13例(16.3%)位于宫角/间质;65例(81.2%)有盆腔积液;超声征象32例(40.0%)为附件区或宫角包块,4例(42.5%)为孕囊或胚芽,14例(17.5%)为胎心及心管搏动。患者均行腹腔镜手术治疗,其中9例(11.3%)发生严重并发症,6例(7.5%)中转开腹手术治疗,50例(62.5%)妊娠自然分娩,21例(26.3%)剖宫产,9例(11.3%)流产。结论:经阴道彩色多普勒超声诊断IVF-ET术后HP的主要手段,诊断符合率近90%,对临床有一定指导意义。Objective:To explore the application of the transvaginal color Doppler ultrasonography for diagnosing the heterotopic pregnancy(HP)of patients after in vitro fertilization-embryo transfer(IVF-ET),and to study the effect of the laparoscopic surgery for treating HP of the patients.Methods:The clinical data of 80patients with HP after IVFET from March 2020to December 2022 were analyzed retrospectively.The accuracy rate diagnosed by ultrasound,the clinical manifestations,the ultrasonogram characteristics,the situations of the laparoscopic surgery and the pregnancy outcomes of the patients were analyzed.Results:The HP of 71patients was diagnosed by transvaginal color Doppler ultrasound,with the diagnostic accuracy rate of 88.8%.There were 4(5.0%)patients with the delayed diagnosis of HP and 5(6.3%)patients with the misdiagnosis of HP.There were 67(83.8%)patients with the ectopic pregnancy in the uterine adnexa and 13(16.3%)patients with the ectopic pregnancy in the uterine horn/stroma.There were 65(81.2%)patients with pelvic effusion.The ultrasound signs showed that there were 32(40.0%)patients with the adnexal or cornual mass,4(42.5%)patients with the gestational sac or gestational germ and 14(17.5%)patients with the fetal heart and the fetal heart tube pulsation.All the patients had undergone laparoscopic surgery,of which,there were 9(11.3%)patients with severe complications and 6(7.5%)patients with the converted to open surgery.After surgery,there were 50(62.5%)patients with spontaneous delivery,21(26.3%)patients with cesarean section and 9(11.3%)patients with spontaneous abortion.Conclusion:Transvaginal color Doppler ultrasonography is the main measure for diagnosing HP of the patients after IVF-ET,and the diagnostic coincidence rate of which is nearly 90%,which has certain guiding significance for treating the patients with HP in the clinical practice.

关 键 词：体外受精-胚胎移植 宫内外复合妊娠 诊断 经阴道彩色多普勒超声 腹腔镜手术 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]