体外受精-胚胎移植术后单胎妊娠子痫前期发病特征分析

目的探讨体外受精-胚胎移植（IVF-ET）术后妊娠发生子痫前期的临床特征。方法回顾性分析2008年1月至2012年12月IVF-ET术后单胎妊娠子痫前期35例（IVF-ET组）和单胎自然妊娠子痫前期126例（自然妊娠组）患者的临床表现、辅助检查及妊娠结局。结果 IVF-ET组子痫前期的发生率为13.13%（211/1607）,与自然妊娠组（4.83%,844/17 483）比较,差异有统计学意义（P〈0.05）;IVF-ET组子痫前期的平均发病时间为妊娠（31.67±6.63）周,自然妊娠组为（33.76±4.46）周,两组比较,差异有统计学意义（P〈0.05）;IVF-ET组分娩孕周为（34.79±5.19）d,自然妊娠组为（34.27±4.30）d,两组比较,差异无统计学意义（P〉0.05）;IVF-ET组前置胎盘发生率为14.29%（5/35）,与自然妊娠组（3.97%,5/126）比较,差异有统计学意义（P〈0.05）;IVF-ET组平均住院时间（20.68±14.61）d]与自然妊娠组（11.96±7.14）d]比较,差异有统计学意义（P〈0.05）;既往妊娠史中,IVF-ET组异位妊娠和自然流产发生率分别为8.57%（3/35）和20.00%（7/35）,自然妊娠组分别为0（0/126）和6.35%（8/126）,两组比较,差异有统计学意义（P〈0.05）。结论 IVF-ET术后妊娠子痫前期的发病率高于自然妊娠,发病时间早,前置胎盘发生率增高。在既往史中,IVF-ET组自然流产与异位妊娠的发生率较高。IVF-ET术后子痫前期患者经过适当的临床干预及期待治疗,有可能延缓子痫前期的进展,延长孕周,降低孕妇并发症的发生,改善妊娠结局。

Analysis of characteristics of preeclampsia in pregnancy after in vitro fertilization and embryo transfer

Objective To explore the different clinical presentation of preeclampsia in pregnancy between IVF- ET group and natural pregnancy group. Methods Singleton pregnancies as the main object of observation, a retrospective study was carried out on 35 IVF - ET singleton pregnancy patients and 126 natural singleton pregnancy patients which were diagnosed as preeciampsia. Clinical presentation, pregnancy outcome and key hiochemical indicator were compared between the two groups. Results The incidence of preeclampsia in IVF- El＂ group was 13. 13% （211/1 607）, compared with natural pregnancy group （4. 83%, 844/17 483）, the difference was statistically sig- nificant （P〈0.05）. There were statistical differences in the early on- set in gestational weeks （31.67±6.63） weeks vs. （33.76±4.46） weeks], incidence of placenta previa （14. 29% vs. 3.97%）, the history of ectopic preg- nancy （8.57% vs. 0） and recurrent abortion （20. 00% vs. 6.35%） between the two groups （P〈0. 05）. The IVF- ET group stayed a longer time in hospital （20.68±5.19） days vs. （11.96±7.14） days, P〈0. 05], but the terminal pregnancy weeks （34. 79±5.19） weeks vs. （34.27±4. 30） weeks, P〈0.05] had no statistically different. Conclusion Higher incidence of preeclampsia, early oneset in gestational weeks, high incidence of placenta previa, the history of ectopic pregnancy and recurrent abortion were the characters of preeclarnpsia in IVF- ET pregnancy patients. Prolonging the hospital stay and a positive clinical intervention were helpful in delaying the progress of preeelampsia, increasing gestational weeks and lowering maternal complications.