超声检查早期诊断体外受精-胚胎移植术后复合妊娠

目的探讨超声检查早期诊断体外受精-胚胎移植术(IVF-ET)后复合妊娠(HP)的价值。方法回顾性分析81例IVF-ET后临床确诊为复合妊娠患者的超声和手术情况,并随访宫内妊娠结局。结果超声诊断HP的时间为IVFET后20~49天,平均(29.08±5.74)天。81例中,术前超声诊断为宫内合并输卵管妊娠70例,宫内合并宫角妊娠8例,宫内合并宫颈妊娠、宫内合并肌壁间妊娠、单侧输卵管妊娠各1例;术前超声误诊3例,漏诊1例;超声诊断符合率为95.06%(77/81)。对77例宫内妊娠情况进行随访,其中60例已分娩或继续妊娠,6例术后宫内胚胎停育而接受清宫术,1例因21-三体高风险而接受引产,10例失访。结论超声检查可早期诊断IVF-ET后HP,指导临床及时治疗。

Ultrasound in early diagnosis of heterotopic pregnancy after in vitro fertilization and embryo transfer

Objective To explore the value of ultrasound in early diagnosis of heterotopic pregnancy (HP) after in vitro fertilization and embryo transfer (IVF-ET).Methods Clinical and ultrasonic data of 81 cases of HP after IVF-ET were retrospectively analyzed, and intrauterine pregnancy results were followed up.Results HP was diagnosed with ultrasound 20-49 (mean29.08±5.74]) days after IVF-ET. Among 81 cases, 70 were diagnosed with intrauterine pregnancy combined with tubal pregnancy, 8 were diagnosed combined with uterine horn pregnancy, 1 was diagnosed combined with cervical pregnancy, 1 was diagnosed combined with intramural pregnancy, 1 was diagnosed as unilateral tube pregnancy, while 3 were misdiagnosed and 1 was missed diagnosis with ultrasound before surgery. The coincidence rate of ultrasound diagnosis before surgery was 95.06% (77/81). During following-up of intrauterine pregnancy results of 77 cases, childbirth or continued gestation were observed in 60 cases, 6 cases underwent surgical termination because of embryo damage, 1 had induction of labor because of high risk of Down''s syndrome, while 10 cases were lost to follow-up.Conclusion Ultrasound is significant in early diagnosis of heterotopic pregnancy after IVF-ET, which can provide proper guidance for clinical treatment.