体外受精-胚胎移植术后复合妊娠研究进展

复合妊娠（heterotopic pregnancy,HP）是一种极其危险的异位妊娠,自然受孕者中HP的发生率并不高,但随着近年体外受精-胚胎移植（in vitro fertilization and embryo transfer,IVF-ET）术以及促排卵技术的普及,HP的发生率较前有所上升。HP患者早期一般仅有腹痛、阴道出血等非特异性症状,且由于宫内妊娠囊的存在使得宫外妊娠囊特别容易误诊和漏诊,从而易导致患者宫外妊娠囊继续发展,引起腹腔内大出血甚至休克等危及生命的严重后果。因此,充分了解HP的相关危险因素,在行ET术或促排卵技术前采取相应的预防HP发生的措施、发生HP后尽早进行确诊及确诊后采取有效的治疗对改善患者的预后显得尤为重要。综述近年IVF-ET后HP的诊断及管理措施进展。

Research Progress of Compound Pregnancy after In Vitro Fertilization and Embryo Transfer

Compound pregnancy (heterotopic pregnancy, HP) is an extremely dangerous ectopic pregnancy. The incidence of HP in natural conception is not high, but in recent years, the popularization of in vitro fertilization and embryo transfer (IVF- ET) and ovulation induction techniques, the incidence of HP has increased compared with the previous period. Patients with HP usually only have non-specific symptoms such as abdominal pain and vaginal bleeding in the early stage. Due to the existence of intrauterine gestation sac, their ectopic gestational sac is especially easy to be misdiagnosed and missed, which can easily lead to the continued development of the patient′s ectopic gestational sac and can cause serious life-threatening consequences such as hemorrhage in the abdominal cavity or even shock. Therefore, a full understanding of the related risk factors of HP, corresponding measures to prevent the occurrence of HP before ET or ovulation induction technology. Early diagnosis after HP and effective treatment after diagnosis will improve the prognosis of patients and it seems particularly important. This review summarizes the progress in diagnosis and management of HP after IVF-ET.