复合妊娠病人早期诊疗管理及产科结局的初步探讨:附本中心18例病例分析

A Preliminary Study on Early Diagnosis and Treatment Management and Obstetric Outcomes in Patients with Heterotopic Pregnancy-An Analysis of 18 Cases in Our Center Is Attached

目的了解超声诊断为复合妊娠的病人的一般特征,为后续制定最佳管理方案提供参考依据和临床资料。方法收集并分析2016年6月—2020年6月至苏州大学附属第一医院就诊记录在案的18例复合妊娠患者的临床资料。结果83.33%的患者通过辅助生殖技术受孕,83.33%的患者有盆腔手术或炎症史,77.78%的患者在孕5~7周时通过超声诊断为复合妊娠,66.67%的患者接受了期待治疗,81.25%合并宫内妊娠的患者成功分娩。结论1.在辅助生殖技术应用中,预处理盆腔炎症,倡导单胚胎移植;2.个体化促排卵用药管理,规避多卵泡周期,可能减少复合妊娠的发生;3.妊娠5~7周常规经阴道超声检查有助于复合妊娠的早期诊断;4.在该研究中,严密监控随访直至附件区异常回声消失的期待治疗发挥了很大的作用。

Objective To characterize general attributes of women diagnosed with heterotopic pregnancy by ultrasound and provide reference basis and clinical data for the establishment of an optimal management regimen.Methods A retrospective analysis was conducted on 18 patients with heterotopic pregnancy recorded at the First Affiliated Hospital of Soochow University between June 2016 to June 2020.Result 83.33%of patients had conceived via assisted reproductive technology(ART),83.33%had a history of pelvic surgery or inflammation,77.78%of patients were diagnosed with heterotopic pregnancy via ultrasound examination at approximately 5-7 weeks of gestation,66.7%of the patients received expectant treatment,81.25%of the patients with intrauterine pregnancy successfully delivered.Conclusion 1.Pretreat pelvic inflammatory disease and advocate single embryo transfer in ART;2.Individualized ovulation induction medication management,avoiding multiple follicular cycle,may reduce the occurrence of heterotopic pregnancy;3.Routine ultrasound examination at 5-7 weeks of gestation is helpful for early diagnosis of heterotopic pregnancy;4.In this study,expectant treatment which including rigorous monitoring and follow-up until the abnormal echo disappears in the accessory played a great role.