孕囊数目对中重度卵巢过度刺激综合征患者出生结局的影响

Influence of number of gestational sac on pregnancy outcome with moderate and severe ovarian hyperstimulation syndrome

目的探讨在中重度卵巢过度刺激综合征妊娠患者中,孕囊数目对妊娠结局和新生儿出生结局的影响。方法选择2011年1月至2014年12月在我院行IVF-ET治疗后患中重度OHSS妊娠的患者共116例,包括重度OHSS患者26例(单孕囊11例,双孕囊15例);中度OHSS患者90例(单孕囊34例,双孕囊55例,三孕囊1例)。按照孕囊个数分为单孕囊组和多孕囊组。统计两组的一般情况;早期流产率,晚期流产率,活产率;母体合并症,婴儿出生情况等。结果⑴单孕囊组和多孕囊患者在年龄、不孕年限、BMI、Gn天数、Gn总量、HCG日E2、获卵数均无差异。⑵单孕囊组和多孕囊组早期流产率有差别(15.6%和4.2%);早期孕囊丢失率无差别(15.2%和9.8%);晚期流产率无差别(8.3%和9.2%),活产率无差别(76.1%和86.6%);多孕囊组中活多胎出生率为69.1%。⑶分娩结局中,单孕囊组和多孕囊组的早产率(18.2%和54.2%)、极低/低体重儿率(17.6%和48.6%)、剖宫产率(54.5%和89.8%)有明显差别。结论在中重度卵巢过度刺激综合症患者中,单孕囊组早期孕囊丢失率和多孕囊组无差别,但早期流产率高,减胎需慎重;多孕囊组的多胎出生率仅69.1%,且早产率、极低/低体重儿率、剖宫产率均高于单孕囊组,对于OHSS高危患者尽量选择单胚胎移植。

Objective To evaluate the obstetric outcome belong on the gestational sac with moderate and severe Ovarian Hyperstimulation Syndrome after in vitro fertilization embryo transfer（IVF-ET） treatment. Methods We retrospectively analyzed 116 infertile patients with moderate and severe Ovarian Hyperstimulation Syndrome after in vitro fertilization embryo transfer（IVF-ET）treatment from January 2012 to December 2014 in the assisted reproductive medicine center of Jiangxi province maternal and child health hospital. The patients were divided into Single gestational sac groups and multiple gestational sac groups. Clinical indicators,maternal complications,pregnancy outcome and neonatal weight were compared. Results ⑴ There was no significantly difference in the age,infertility duration,the days and dose of Gn,the estradiol in HCG day,number of retrieved oocytes between the two groups. ⑵There is no distinction at the early pregnancy sac loss rate between the two groups,but the early abortion rate in the Single gestational sac group was significantly higher than the multiple gestational sac groups. There was no significantly difference in the late abortion rate and the live birth rate between the two groups. The multiple live birth rates in the multiple gestational sac group was only 69.1%. ⑶The premature birth rate,the low weight infant rate and the Caesarean delivery rates in the multiple gestational sac groups were significantly higher than the Single gestational sac group. Conclusion There is no distinction at the early pregnancy sac loss rate between the two groups,but the early abortion rate in the Single gestational sac groups was significantly higher than the multiple gestational sac groups in the patients with moderate and severe Ovarian Hyperstimulation Syndrome. We need to be more cautious to choose embryo reduction. The multiple live birth rates in the multiple gestational sac groups was only 69.1%,and there were more complications. Therefore,single embryo transfer was better.