宫内妊娠合并输卵管间质部或宫角妊娠38例临床分析并文献复习

Clinical analysis of 38 cases of heterotopic interstitial pregnancy or heterotopic cornual pregnancy and literature review

目的 探讨宫内妊娠合并输卵管间质部或宫角妊娠的临床特点及腹腔镜手术治疗后宫内妊娠结局。方法回顾性分析并随访2011年1月至2022年12月在复旦大学附属妇产科医院经腹腔镜手术治疗确诊为宫内妊娠合并输卵管间质部或宫角妊娠患者38例的病例资料及宫内妊娠结局,并检索相关文献进行分析。结果 共有21例患者确诊为宫内妊娠合并宫角妊娠,17例确诊为宫内妊娠合并输卵管间质部妊娠;35例(92.1%,35/38)为体外受精-胚胎移植术后,24例有输卵管切除术或者结扎术等手术史;10例行腹腔镜下宫角切除术,28例行切开取胚术;3例早孕期胚胎停育流产,35例活产。结论 腹腔镜手术治疗宫内妊娠合并输卵管间质部或宫角妊娠安全有效,术后多数可获得满意的妊娠结局。

Objective To investigate the clinical features of heterotopic interstitial pregnancy or heterotopic cornual pregnancy,as well as the outcome of intrauterine pregnancy after laparoscopic surgery management.Methods A retrospective analysis of clinical characteristics and intrauterine pregnancy outcomes was performed on 38 cases of heterotopic interstitial pregnancy or heterotopic cornual pregnancy following laparoscopic surgery in Obstetrics&Gynecology Hospital of Fudan University between January 2011 and December 2022,and a literature review was made.Results There were 21 patients who were diagnosed with heterotopic cornual pregnancy and 17 patients with heterotopic interstitial pregnancy;35(92.1%)patients conceived via in vitro fertilization and embryo transfer;24 patients had a history of tubal surgery;10 patients underwent laparoscopic cornual resection and the remaining 28 patients underwent laparoscopic cornuostomy;3 patients ended up with abortion and 35 neonates were delivered.Conclusion Laparoscopic surgery is safe and effective for heterotopic interstitial pregnancy or heterotopic cornual pregnancy,and most patients can achieve good maternal and fetal outcomes.