体外受精—胚胎移植后宫内妊娠合并子宫瘢痕妊娠1例并文献复习

Heterotopic cesarean scar pregnancy following in vitro fertilization-embryo transfer:a case report

宫内妊娠合并瘢痕妊娠(HCSP)是宫内妊娠(IUP)与剖宫产瘢痕妊娠(CSP)共存的一种少见但风险性极高的女性生殖系统疾病。治疗HCSP最大的难题是如何在处理CSP的同时保留IUP。本文报道1例体外受精-胚胎移植后宫内妊娠合并瘢痕妊娠的病例并进行了文献复习,希望为HCSP的治疗提供一些思路。该患者取卵5枚,移植2枚胚胎后成功妊娠,1枚胚胎定植于宫腔正常位置,另1枚着床于前次剖宫产瘢痕切口处,两胚胎均存活。经期待治疗后瘢痕处的胚胎停育(仅见缩小的胚囊,胎心搏动消失),患者最终获得良好结局。

Heterotopic caesarean scar pregnancy(HCSP),a rare but high-risk female reproductive system disease, is defined as the co-existence of intrauterine pregnancy(IUP) and cesarean scar pregnancy(CSP). The most intractable challenge is how to preserving IUP while healing the CSP. This article reports a case of HCSP following in vitro fertilization-embryo transfer and reviews some academic literatures and journal articles, hoping to provide inspiration for the treatment of HCSP. The patient obtained 5 embryos and had gemellary pregnancy, one implanted in the uterine cavity, the other located at the scar incision of the previous cesarean. The scar embryo were aborted after the expectant treatment and the patient finally deliverd a fine baby boy.