辅助生殖技术异位妊娠特点及高危因素分析

Analysis the characteristics and high-risk factors of ectopic pregnancy after assisted reproductive technology

目的探讨辅助生殖技术(ART)后异位妊娠(EP)特点及高危因素,以期制定针对性干预措施进行EP预防。方法选择2015年6月至2018年6月我院收治的100例ART后EP患者作为观察组,随机选择同期行ART后正常妊娠的100例患者作为对照组,比较两组不孕类型、输卵管手术史等病历资料,采用单因素分析与及多因素logistic回归分析ART后EP的独立危险因素。结果100例ART后EP中输卵管妊娠88例,宫内外同时妊娠8例,宫角妊娠21例,宫颈妊娠2例;两组患者不孕类型、输卵管手术史、人工流产史、盆腔输卵管因素不孕、绒促性素(HCG)日子宫内膜厚度、年龄比较差异具有统计学意义(P<0.05),两组胚胎移植个数、HCG日孕酮(P)、黄体生成素(LH)、雌二醇(E2)水平、EP史、受精方式比较差异无统计学意义(P>0.05);多因素logistic回归分析显示,输卵管手术史、人工流产史、盆腔输卵管因素不孕、HCG日子宫内膜厚度<10 mm是ART后EP的独立危险因素(P<0.05)。结论ART后EP危险因素众多,包括输卵管手术史、人工流产史、盆腔输卵管因素不孕以及HCG日子宫内膜厚度等,应对EP高危患者开展针对性干预措施以降低EP风险。

Objective To explore the characteristics and high-risk factors of ectopic pregnancy(EP)after assisted reproductive technology(ART)in order to develop targeted interventions for EP prevention.Methods We selected 100 cases of patients with EP after ART who were treated in our hospital from June 2015 to June 2018 as an observation group,and 100 patients with normal pregnancy who underwent ART during the same period were randomly selected as a control group.The case data such as type of infertility and history of fallopian tube surgery were compared between the two groups.Univariate analysis and multivariate logistic regression were used to analyze independent risk factors for EP after ART.Results There were 88 cases of tubal pregnancy in 100 cases of EP after ART,8 cases of simultaneous pregnancy in inside and outside of the uterus,21 cases of uterine horn pregnancy,and 2 cases of cervical pregnancy.There were statistically significant differences in the types of infertility,history of fallopian tube surgery,history of abortion,infertility due to the factors of the pelvic tubal,endometrial thickness after using chorionic gonadotropin(HCG)and age of in the two groups(P<0.05).In two groups,the difference was not statistically significant in the number of embryos transplantation,progesterone(P)after using HCG,luteinizing hormone(LH),and levels of estradiol(E2),history of EP,and fertilization methods(P>0.05).Multivariate logistic regression analysis showed that the history of fallopian tube surgery,history of induced abortion,infertility due to the factors of the pelvic tubal,and endometrial thickness after using HCG<10 mm were independent risk factors for EP after ART(P<0.05).Conclusion There were many risk factors for EP after ART,including history of fallopian tube surgery,history of induced abortion,infertility due to the factors of the pelvic tubal,and endometrial thickness after using HCG.Targeted interventions should be carried out to reduce the risk of EP in high-risk patients.