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目的探讨体外受精-胚胎移植(IVF-ET)术后宫内合并宫外妊娠的发病因素和临床特征。方法对2009年1月至2014年4月IVF-ET术后5例宫内合并宫外妊娠患者的受孕方式、临床症状、辅助检查、治疗方法及妊娠结局进行回顾性分析。结果 5例患者中,IVF-ET术后第12~14天测尿或血β-hCG及阴道超声确定宫内合并宫外妊娠,其中腹痛4例,阴道出血4例,晕厥、休克1例。1例合并宫角妊娠,4例合并输卵管妊娠。输卵管切除5例,部分宫角切除1例。术后阴道出血或腹痛明显改善后定期产前检查,现2例已足月分娩,2例继续妊娠中,1例术后第1天宫内妊娠自然流产。结论 B超检查可及早发现宫内合并宫外妊娠,手术为其首选,早诊断、早治疗患者预后良好。
Objective To investigate the etiological factors and clinical features of intrauterine uterine complications after ectopic pregnancy after IVF-ET. Methods Retrospective analysis was made on the methods of pregnancy, clinical symptoms, auxiliary examination, treatment and pregnancy outcome in 5 cases of intrauterine uterine merger with ectopic pregnancy after IVF-ET from January 2009 to April 2014. Results In 5 patients, intrauterine uterine bleeding complicated with ectopic pregnancy was determined by urine or blood β-hCG and vaginal ultrasound on the 12th to 14th days of IVF-ET. There were 4 cases of abdominal pain, 4 cases of vaginal bleeding, syncope and shock. 1 case complicated with cornual pregnancy, 4 cases of tubal pregnancy. Fallopian tube resection in 5 cases, partial hysterectomy in 1 case. Postoperative vaginal bleeding or abdominal pain was significantly improved after regular antenatal examination, 2 cases have been full-term delivery, 2 cases of continued pregnancy, 1 case of intrauterine pregnancy after the first day of spontaneous abortion. Conclusion B-ultrasound early detection of intrauterine pregnancy combined with ectopic pregnancy, surgery for its preferred early diagnosis and early treatment of patients with good prognosis.