体外受精-胚胎移植后宫内外同时妊娠不同处理方法的结局比较

Comparison of the outcomes of different administrations of heterotopic pregnancy after in vitro fertilizationembryo transfer

目的:比较分析体外受精-胚胎移植(IVF-ET)后宫内外同时妊娠不同处理方法的结局。方法:回顾性收集本院IVF-ET术后同时妊娠患者资料50例。根据处理方法的不同分为保守观察组(n=16)、开腹手术组(n=18)、经阴道穿刺治疗组(n=3)和腹腔镜手术组(n=13)。比较各组宫内妊娠结局。结果:把早产及足月产归为妊娠成功,排除安胎中病例,保守观察组、开腹手术组、经阴道穿刺治疗组、腹腔镜手术组的成功率为78.6%、76.5%、66.7%、54.5%,差异无显著性(P均>0.05)。结论:各种处理方法的宫内妊娠结局无明显差异,提示对于无症状或者异位妊娠症状不严重者可先进行保守观察,病情出现恶化时方进行相应的干预处理。

Objective To compare the outcomes of different administrations of heterotopic pregnancy（HP） after in vitro fertilization-embryo transfer（IVF-ET）.Methods Clinical data of 50 cases with HP after IVF-ET were retrospectively analyzed.All patients were divided into 4 groups：conservative observation group（n = 16）,laparotomy group（n = 18）,transvaginal puncture group（n = 3） and laparoscopic surgery group（n = 13）.The intrauterine pregnant outcomes of patients in each group were compared.Results When successful pregnancy was defined as pre-term or in-term delivery,and when the cases still in pregnant right now were excluded,the successful pregnant rate in conservative observation group was 78.6%,which was not significantly higher than those in laparotomy group,transvaginal puncture group and laparoscopic surgery group（63.6%,66.7% and 50.0% ;P = 0.656,1.0,0.204）.Conclusion The intrauterine pregnant outcomes were not significantly different among the 4 groups,which indicated that in asymptomatic patients or patients with moderate symptoms,conservative observation could be administered firstly.