体外受精-胚胎移植后妊娠产科结局分析

目的　研究体外受精 胚胎移植 (IVF ET)术后妊娠的母儿围生期特点。方法　采用病例对照方法 ,选择行IVF ET术后妊娠并于 1993年 1月至 2 0 0 2年 12月分娩的妇女 2 5 5例 ,与同期分娩的自然受孕的妇女17175例对照 ,研究IVF ET术后妊娠的围生期情况。结果　IVF ET单胎妊娠的早产、前置胎盘、糖耐量试验(OGTT)异常、产后出血、剖宫产率高于自然受孕组 ,P <0 0 5。IVF ET双胎妊娠的分娩孕周、新生儿体重低于单胎妊娠 ,P <0 0 5 ;中度及重度妊娠期高血压疾病 (妊高征 )、胎膜早破发生率高于单胎妊娠 ,P <0 0 5。结论　IVF ET妊娠是高危妊娠 ,多胎妊娠率高是导致早产和低体重儿显著增多的主要原因 ,加强孕期保健 ,及时治疗并发症可获得良好的妊娠结局。

Obstetric outcome of in vitro fertilization pregnancies

Objective To evaluate the perinatal outcome of pregnancy after in vitro fertilization and embryo transfer(IVF-ET).Methods Perinatal outcome of 255 pregnancies after IVF-ET was compared to that of 17175 pregnancies with normal fertility within the same period between January 1993 to December 2002.Results The occurrences of preterm delivery,placenta previa,OGTT abnormal,postpartum hemorrhage,and cesarean section were more in singleton pregnancies after IVF-ET than in normal gestation,P<0.05.Compared to singleton pregnancies,multiple pregnancies after IVF-ET were with more preterm delivery,low-birth weight,moderate and severe hypertensive disorder complicating pregnancy and preterm rupture of membrane,P<0.05.Conclusion Pregnancy after IVF-ET is of high risk.Multiple pregnancy after IVF-ET is the main etiology for preterm delivery and low birth weight.Paying attention to perinatal care and treating the complication in time are beneficial to pregnancy outcome.