宫内妊娠合并异位妊娠的治疗挑战

Treatment Challenges of Heterotopic Pregnancy

宫内妊娠合并异位妊娠是指宫内妊娠与异位妊娠同时存在,这种罕见疾病的发生率随着辅助生殖技术的应用显著升高。异位妊娠部位可包括输卵管、宫颈、卵巢、腹腔以及剖宫产切口。由于其临床表现不典型,加之宫内妊娠的干扰,临床上常漏诊、误诊及延误治疗,从而导致严重的并发症。治疗方法包括期待、穿刺、手术等。治疗方式的选择需要根据患者的意愿、异位妊娠部位及患者病情等综合考虑,实施个体化治疗。对于想要保留宫内妊娠的患者,在治疗异位妊娠的同时,如何避免对宫内妊娠造成影响仍是目前临床治疗面临的挑战。

Heterotopic pregnancy refers to the coexistence of intrauterine and ectopic pregnancies. The incidence of this rare disease significantly increased with application of assistant reproductive technology. The ectopic pregnancies usually occur in the fallopian tube, cervix, ovary, abdomen and previous cesarean scar. Because of the atypical clinical manifestations and the interference of intrauterine pregnancy, many cases could be missed diagnosis, misdiagnosed and delayed treatment, which always leads to serious complications. The treatment options for heterotopic pregnancy include expectant treatment, fetal reduction, surgery, and so on. The treatment should be individualized, based on patient′s preference, ectopic pregnancy site, clinical symptoms and signs. At the same time, it is still the treatment challenges how to avoid the impact of the treatment procedure of ectopic pregnancy on intrauterine pregnancy, for those patients who want to keep their intrauterine pregnancies.