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目的 探讨体外受精 -胚胎移植 (IVF -ET)后宫内外同时妊娠 (HP)的发生率、危险因素、诊断及防治方法。方法 对IVF -ET后发生宫内外同时妊娠 6例病例进行回顾性分析。结果 宫内外同时妊娠的发生率为 0 95 %。 6例病人均移植 3个以上胚胎 ,4例有盆腔或输卵管疾病史 ;宫内外同时妊娠症状以腹痛为主 ,2例伴腹肌紧张及低血容量休克 ,3例有阴道流血。 6例病人中 2例经B超确诊 ,3例经手术确诊 ,1例误诊为阑尾炎。1例行输卵管修补术 ,余行输卵管切除术治疗 ,其中 2例自然分娩活婴。结论 IVF -ET后HP发生率明显增加 ,特别是有盆腔、输卵管疾病史或移植多个胚胎者。加强B超监测 ,有助于在妊娠部位破裂前发现、诊断及治疗HP ,防止不良后果发生。
Objective To investigate the incidence, risk factors, diagnosis and prevention and treatment of simultaneous intrauterine and uterine pregnancy after IVF-ET (IVF-ET). Methods Six cases of intrauterine and extrauterine pregnancy after IVF-ET were retrospectively analyzed. Results The incidence of intrauterine and external pregnancy was 0 95%. All of the 6 patients had more than 3 embryos transplanted, and 4 had pelvic or tubal disease history. The intrauterine and extrauterine pregnancy symptoms were mainly abdominal pain, 2 patients had abdominal muscle tension and hypovolemic shock, and 3 patients had vaginal bleeding. Two of six patients were diagnosed by B ultrasound, three were confirmed by surgery, and one was misdiagnosed as appendicitis. A routine tubal repair surgery, the remaining line of tubal resection, of which 2 cases of natural childbirth live baby. Conclusions The incidence of HP increased significantly after IVF-ET, especially in patients with pelvic or tubal disease or multiple embryos. To strengthen B-monitoring, help to find, diagnose and treat HP before rupture of the pregnancy, to prevent the adverse consequences.