目的 探讨胚胎移植术后输卵管间质部妊娠的发生率、发病影响因素、治疗、妊娠结局等,以加强临床医生对输卵管间质部妊娠的认识. 方法 回顾性分析我中心2014年1月1日至2016年12月31日胚胎移植术后输卵管间质部妊娠的21例病例的临床资料. 结果 我中心2014年1月1日至2016年12月31日胚胎移植术后临床妊娠病例共6 487例,输卵管间质部妊娠21例,发病率为0.32％(21/6 487),其中14例(66.67％)有输卵管手术史;20例行腹腔镜治疗,1例保守治疗成功;输卵管间质部合并宫内妊娠8例,经腹腔镜治疗后3例成功抱婴,1例术后宫内胎儿存活(目前妊娠至28周),2例术后宫内妊娠难免流产行清宫术,2例因胚胎停育行清宫术. 结论 输卵管手术史是导致输卵管间质部妊娠的重要因素;腹腔镜是治疗输卵管间质部妊娠的有效方法;腹腔镜治疗输卵管间质部合并宫内妊娠,有利于宫内妊娠获得良好的妊娠结局.现有的输卵管切除和阻断方式需改进,以减少输卵管间质部妊娠的发生.%Objective:To explore the incidence,influence factor,diagnosis,treatment and pregnancy outcome,etc.for interstitial pregnancy(IP)after embryo transfer in order to strengthen the clinicians'understanding interstitialpregnancy.Methods:The data of 21 patients with IP after the embryo transfer in our center from 1st January 2014 to 31st December 2016 were retrospectively analyzed.Results:A total of 6 487 patients got clinical pregnancies after the IVF-ET in our center from 1st January 2014 to 31st December 2016.Among them,interstitial pregnancy was occurred in 21 patients,and IP incidence was 0.32％(21/6 487).Among 21 patients with IP,14 patients had a history of fallopian tube operation.Twenty patients were treated with laparoscopic surgery,and one patient had conservative treatment successfully.Eight patients had interstitial pregnancy combined intrauterine pregnancy.Three patients had live birth after laparoscopic treatment.One patient'fetus was survival after laparoscopy intrauterine(current pregnancy to 28 weeks).Two patients had uterine curettage due to inevitable abortion,and 2 patients had uterine curettage due to embryo arrest.Conclusions:The history of fallopian tube operation is a key factor for interstitial pregnancy occurrence.Laparoscopic surgery is an effective diagnosis and treatment for interstitial pregnancy.Laparoscopic surgery applied in interstitial pregnancy combined intrauterine pregnancy can achieve good pregnancy outcome of intrauterine pregnancy.More effective fallopian tube surgical method should be explored,in order to decrease IP incidence.
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