胚胎移植后宫内宫外复合妊娠18例临床分析

Clinical analysis of heterotopic pregnancy after embryo transfer in 18 patients

目的探讨胚胎移植后宫内宫外复合妊娠发生的临床特点。方法回顾性分析18例胚胎移植后宫内宫外复合妊娠患者的临床资料。结果18例患者均因输卵管因素接受体外受精胚胎移植,其中3例丈夫患弱精子症;3例早期腹痛时、10例移植后28d、5例移植后35d行阴道超声检查确诊;7例行开腹手术,11例行腹腔镜手术;18例患者中12例分娩健康活婴,6例终止妊娠。结论输卵管因素不孕有可能导致胚胎移植后发生宫内宫外复合妊娠,及时诊断和治疗可获得较好妊娠结局。

Objective To investigate the clinical characteristics of heterotopic pregnancy after embryo transfer. Methods The clinical data of 18 patients with heterotopic pregnancy after embryo transfer were analyzed retrospectively. Results All 18 patients received in vitro fertilization and embryo transfer due to fallopian tube diseases, in which 3 patients’ husbands were diagnosed with asthenospermia. Vaginal ultrasonography was performed for a definite diagnosis in 3 patients with early abdominal pain, 10 patients on day 28 after transplantation and 5 patients on day 35 after transplantation. Seven patients were performed laparotomy and 11 patients were performed laparoscopic surgery. Among 18 patients, 12 delivered healthy live infants, and 6 were terminated pregnancy. Conclusion Fallopian tube disease probably causes heterotopic pregnancy after embryo transfer. Better pregnancy outcomes can be achieved by timely diagnosis and correct treatment.