辅助生殖技术后复合妊娠49例的临床特点及治疗方式

Clinical characteristics and treatment methods of 49 cases of heterotopic pregnancy after ART

目的分析辅助生殖技术(ART)后复合妊娠(HP)的临床特点,探讨减胎术与腹腔镜手术两种不同治疗方式的妊娠结局。方法收集本院收治的49例辅助生殖技术后经阴道超声诊断为复合妊娠患者的临床资料,分析其临床特点,并以减胎术和腹腔镜手术分组比较两组术后活产率及流产率。结果(1)46.9%患者有输卵管手术史,26例无输卵管手术史的患者中,69.2%有输卵管结构或功能障碍;(2)第一次经阴道超声检查对复合妊娠的漏诊率达20.2%;(3)B超引导下减胎组的活产率为87.5%,高于腹腔镜手术组(80.5%),差异无统计学意义(P>0.05),但减胎术并发症发生率高(25%)。结论 B超引导下减胎为一种有效的方法,术后活产率高达87.5%,但其并发症发生率较高(25%)。

Objective To analyze the clinical characteristics of heterotopic pregnancy and the pregnancyoutcome of two different treatments of embryo reduction and laparoscopic surgery. Methods The clinical data of49 cases of heterotopic pregnancy after ART diagnosed by transvaginal ultrasound in our hospital were collected.Their clinical characteristics were analyzed. The rate of live delivery and miscarriage were compared between thetwo groups. Results（1）Fallopian tube surgery history,structure or function abnormality were high risk factorsfor heterotopic pregnancy;（2）the missed diagnosis rate of the first TVS for heterotopic pregnancy was as high as20.2%;3.the live birth rate of embryo reduction under B ultrasound guided group was 87.5%,higher than laparo-scopic group（80.5%）,but not statistically significant,the postoperative complication rate of embryo reductionunder B ultrasound guided group was high（25%）. Conclusion Embryo reduction under B ultrasound guided isan effective treatment for heterotopic pregnancy,the live birth rate postoperative as high as 87.5%,but the postop-erative complication rate was also high（25%）.