体外受精—胚胎移植后多部位妊娠10例临床分析及文献复习

目的:探讨体外受精-胚胎移植(IVF-ET)后多部位妊娠的高危因素、诊断及治疗。方法:回顾性分析我院生殖医学中心2013年1月—2015年12月收治的10例IVF-ET术后多部位妊娠病例。结果:因输卵管因素行IVF的9例,其中8例有盆腔手术史。9例多部位妊娠患者初诊得以超声诊断。10例患者均予手术治疗,包括腹腔镜手术7例,经阴道减胎术3例。术后娩出8例健康胎儿。结论:输卵管炎性疾病或盆腔手术史的患者是多部位妊娠的高危因素;诊断首选经阴道超声;腹腔镜手术对宫内妊娠合并输卵管妊娠或宫角妊娠安全有效;宫内妊娠合并宫颈妊娠或瘢痕妊娠推荐经阴道超声选择性减胎术。

Heterotopic Pregnancy after in Vitro Fertilization and Embryo Transfer:A Clinical Analysis of 10 Cases

Objective: To investigate the high risk factors,clinical characteristics and treatment of heterotopic pregnancy (HP) after in vitro fertilization and embryo transfer (IVF-ET). Methods: Ten cases of HP after IVF-ET were analyzed retrospectively. Results: 9 of 10 HP patients suffered from tubal factor infertility. 8 of them had previous pelvic surgeries. 9 cases were diagnosed HP via ultrasound in the first visit. Operation was performed for all 10 cases,including 7 laparoscopes, 3 selective reductions. 8 patients got their healthy babies after operation. Conclusions: A history of tubal inflammatory disease and pelvic surgeries are the risk factors of HP. Transvaginal ultrasound is the first choice for HP diagnosis. Laparoscopy can be the safe and effective treatment for the HP of uterine pregnancy combined with heterotopic tubal or corneal pregnancy. Selective fetal reduction via transvaginal ultrasound can be recommended for the HP of uterine pregnancy combined with heterotopic cervical or cesarean scar pregnancy.