【摘要】 目的:探讨体外受精-胚胎移植术后复合妊娠的临床表现、诊断、治疗方法及妊娠结局。方法:回顾性分析北京大学第一医院自2001年1月至2013年12月接受体外受精-胚胎移植(IVF-ET)治疗后发生宫内宫外复合妊娠3例患者的临床资料。结果:第1例患者因移植后5周宫外妊娠囊破裂行急诊开腹双侧输卵管切除术,术后宫内胚胎继续妊娠至16周,无明显诱因发生流产;第2例患者移植后8周入院,入院即发现宫内胚胎停育,阴式超声发现宫外妊娠囊,行清宫术+腹腔镜双侧输卵管切除术治疗;第3例患者经阴式彩超发现复合妊娠,行腹腔镜下右输卵管切除术,术后宫内妊娠囊继续发育,现至28周。结论:复合妊娠缺乏典型临床表现,早期诊断困难,临床医生应高度警惕复合妊娠发生,并及时采取以手术为主的治疗措施,最大程度保护患者生命、生育能力及宫内胚胎存活。更多还原

【Abstract】 Objectives: To investigate the clinical manifestations,diagnosis,therapy and outcomes of heterotopic pregnancy after in vitro fertilization and embryo transfer( IVF-ET). Methods: 3 cases of heterotopic pregnancy after IVF-ET were analyzed retrospectively between January 2001 and December 2013 in Peking University First Hospital. Results: The 1st patient received emergency laparotomy bilateral tubal resection for the broken of sac caused by ruptured ectopic pregnancy. And the pregnancy continues until found abortion without any obvious incentive after 16 weeks. The 2nd one found intrauterine fetal demise when admitted into the hospital. And the ultrasound found ectopic gestational sac,then the patient received curettage and laparoscopic tubal resection. The last patient was found heterotopic pregnancy by transvaginal ultrasound and was received salpingectomy( right tube removed)with laparoscopic. Now the intrauterine gestational sac continued to develop. Conclusion: It is difficult to diagnose at the early stage of heterotopic pregnancy for the shortage of typical clinical manifestations. Clinicians should pay more attention to it and take timely treatment based on surgery,so as to protect patients,their fertility and embryo.更多还原