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[目的]探讨体外授精-胚胎移植(IVF-ET)术后宫内外同时妊娠(HP)的发生原因、诊断及处理方法。[方法]对IVF-ET术后发生HP 4例进行回顾性分析。[结果]宫内外同时妊娠发生率为0.8%(4/530)。4例患者中,宫内合并宫角妊娠2例,宫内合并左、右输卵管壶腹部妊娠各1例。3例手术治疗,1例宫角妊娠的胚胎停止发育。结局:1例术后宫内胚胎难免流产,3例于孕晚期分娩活婴。[结论]对有输卵管疾病史,IVF-ET术后出现腹痛和阴道出血,须注意宫内外同时妊娠的可能。加强B超监测,早期诊断和治疗HP,可防止不良结局发生。
[Objective] To investigate the causes, diagnosis and treatment of simultaneous intrauterine and extrauterine pregnancy (HP) after IVF-ET. [Methods] Four cases of HP after IVF-ET were retrospectively analyzed. [Results] The incidence of simultaneous intrauterine and external pregnancy was 0.8% (4/530). In 4 patients, intrauterine pregnancy in 2 cases of uterine contractions, intrauterine merger of left and right tubal ampulla pregnancy in 1 case. 3 cases of surgical treatment, 1 case of cornual pregnancy embryos stop development. Outcome: One case of postoperative intrauterine embryos is inevitable abortion, three cases of live birth in the third trimester of pregnancy. [Conclusion] The history of tubal disease, IVF-ET postoperative abdominal pain and vaginal bleeding, should pay attention to the possibility of simultaneous intrauterine pregnancy. To strengthen B-monitoring, early diagnosis and treatment of HP, to prevent adverse outcomes.