辅助生殖技术后异位妊娠发生的类型及危险因素探讨

Study on the types and risk factors of ectopic pregnancy after assisted reproductive technology

目的探讨辅助生殖技术后异位妊娠发生的类型和危险因素。方法回顾性分析,将2014年6月至2017年6月在上海市第八人民医院妇产科接受辅助生殖技术(ART)后80例异位妊娠(EP)患者作为EP组,并将同期上海市第八人民医院妇产科80例行ART后宫内正常妊娠(IUP)患者作为IUP组,观察输卵管妊娠、宫角妊娠、宫内外同时妊娠及腹腔妊娠等异位妊娠的类型,并对其危险因素给予单因素及多因素Logistic回归分析。结果 80例EP组患者中,69例(86.25%)为输卵管妊娠,5例(6.25%)为宫角妊娠,3例(3.75%)为宫内外同时妊娠;经过单因素Logistic回归分析,与IUP组相比,EP组在继发不孕、既往人工流产史、输卵管手术史以及人绒毛膜促性腺激素(HCG)日子宫内膜厚度方面,差异均具有统计学意义(P<0.05);多因素回归分析显示,ART后异位妊娠发生与继发不孕、输卵管手术史以及HCG日子宫内膜厚度密切相关(P<0.05)。结论 ART后异位妊娠与继发不孕、输卵管手术史、HCG日子宫内膜厚度等因素密切相关,应加强临床关注,给予有效的控制措施。

Objective To investigate the types and risk factors of ectopic pregnancy after assisted reproductive technology. Methods From June 2014 to June 2017,80 patients with ectopic pregnancy（ EP） who received assisted reproductive technology（ ART） in the obstetrics and gynecology department of Shanghai Eighth People＇s Hospital were selected as EP group. Eighty People＇s Hospital of Obstetrics and Gynecology obstetrics and gynecology 80 ART routine intrauterine normal pregnancy（ IUP） patients as IUP group,to observe tubal pregnancy,cornual pregnancy,intrauterine and external pregnancy and abdominal pregnancy and other ectopic pregnancy types,and its risk. The factors were given univariate and multivariate logistic regression analysis. Results Among the 80 EP patients,69（ 86. 25%） were tubal pregnancies,5（ 6. 25%） were horn-angle pregnancies and 3（ 3. 75%） were intrauterine and extrauterine pregnancies. After univariate Logistic regression analysis,compared with the EP group,there were significant differences in the history of secondary infertility,previous history of induced abortion,history of tubal surgery,and endometrial thickness of human chorionic gonadotropin（ HCG）（ P〈0. 05）. Multiple factors Regression analysis showed that the occurrence of ectopic pregnancy after ART was closely related to the history of secondary infertility,tubal surgery and endometrial thickness on HCG day（ P〈0. 05）. Conclusion Ectopic pregnancy after ART is closely related to such factors as secondary infertility,history of tubal surgery and endometrial thickness on HCG day. Clinical attention should be intensified and effective control measures should be given.