Surgical treatment of fallopian tubal pregnancy and interstitial pregnancy has no differential effect on intrauterine pregnancy after in vitro fertilization-embryo transfer.

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

BMC Pregnancy and Childbirth Pub Date : 2024-11-18 DOI:10.1186/s12884-024-06943-9

Mingxiang Zheng, Yangqin Peng, Pei Cai, Qingwen He, Gong Fei, Chen Hui, Yuyao Mao, Xihong Li, Yan Ouyang

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引用次数: 0

Abstract

Background: Due to the specific nature of interstitial pregnancy (IP), there are significant risks to both the mother and the foetus in women with a heterotopic interstitial pregnancy (HIP). IP alone has been analysed as a site-specific ectopic pregnancy (EP) in previous studies; however, according to the latest European Society of Human Reproduction and Embryology criteria, IP is classified as a tubal pregnancy. If IP can be classified as a tubal pregnancy, then there is no difference in the effects of these two methods on intrauterine pregnancies (IUPs). Under the premise of timely surgery, disposing of IPs and tubal pregnancy (excluding IPs) should also have no differential effect on IUPs.

Methods: Patients with heterotopic fallopian tubal pregnancy (HP-tube) and HIP seen at our hospital from January 2005 to December 2020 were included. All included patients were diagnosed by transvaginal sonography (TVS), and EPs were confirmed by surgery and pathological analysis. The IUP outcomes after surgical treatment of the EPs were compared between the HP-tube group (n = 464) and the HIP group (n = 206). The outcomes of IUPs were evaluated in patients with HIP who underwent either laparoscopy (169 cases) or laparotomy (36 cases).

Results: There was no significant difference in postoperative miscarriage (6.90% vs. 6.80%, odds ratio (OR) = 1.859, 95% confidence interval (CI) (0.807-4.279), p = 0.145); early spontaneous miscarriage (19.61% vs. 18.93%, OR = 0.788, 95% CI (0.495-1.255), p = 0.316); or late miscarriage (0.43% vs. 0.49%, OR = 0.823, 95% CI (0.070-9.661), p = 0.877) between the HP-tube group and the HIP group. There was no significant difference between the two groups in terms of preterm birth (7.33% vs. 6.80%, OR = 1.044, 95% CI (0.509-2.139), p = 0.907), live birth rate (71.60% vs. 73.30%, OR = 1.010, 95% CI (0.670-1.530), p = 0.980), or perinatal mortality rate (2.00% vs. 0.65%, OR = 0.580, 95% CI (0.030-3.590), p = 0.620). Compared to laparotomy for HIPs, laparoscopic treatment was associated with similar rates of postoperative miscarriage (5.33% vs. 13.90%, p = 0.076), live birth rate (72.80% vs. 75.00%, p = 0.948), caesarean Sect. (83.90% vs. 77.80%, p = 0.414).

Conclusions: After early diagnosis and treatment of EPs, patients in the HP-tube and HIP groups achieved comparable outcomes. Laparotomy and laparoscopy for treating HIPs yielded similar pregnancy outcomes.

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输卵管妊娠和间质部妊娠的手术治疗对体外受精-胚胎移植后的宫内妊娠没有不同的影响。

背景：由于间质妊娠（IP）的特殊性，患有异位间质妊娠（HIP）的妇女对母亲和胎儿都有很大的风险。在以往的研究中，单纯的 IP 被分析为特定部位的异位妊娠（EP）；然而，根据欧洲人类生殖与胚胎学会的最新标准，IP 被归类为输卵管妊娠。如果 IP 可以归类为输卵管妊娠，那么这两种方法对宫内妊娠（IUP）的影响就没有区别。在及时手术的前提下，处理 IP 和输卵管妊娠（不包括 IP）对宫内妊娠的影响也应该没有差异：方法：纳入 2005 年 1 月至 2020 年 12 月在我院就诊的异位输卵管妊娠（HP-tube）和 HIP 患者。所有纳入患者均通过经阴道超声检查（TVS）确诊，并通过手术和病理分析确诊EP。比较了HP管组（n = 464）和HIP组（n = 206）手术治疗EP后的IUP结果。对接受腹腔镜手术（169例）或开腹手术（36例）的HIP患者的IUP疗效进行了评估：结果：术后流产（6.90% vs. 6.80%，几率比（OR）= 1.859，95% 置信区间（CI）（0.807-4.279），P = 0.145）、早期自然流产（19.61%对18.93%，OR=0.788，95% CI（0.495-1.255），P=0.316）；或HP管组与HIP组之间的晚期流产（0.43%对0.49%，OR=0.823，95% CI（0.070-9.661），P=0.877）。在早产率（7.33% vs. 6.80%，OR = 1.044，95% CI (0.509-2.139)，P = 0.907）、活产率（71.60% vs. 73.30%，OR = 1.010，95% CI (0.670-1.530)，p = 0.980）或围产期死亡率（2.00% vs. 0.65%，OR = 0.580，95% CI (0.030-3.590)，p = 0.620）。与开腹手术治疗HIPs相比，腹腔镜治疗的术后流产率（5.33% vs. 13.90%，p = 0.076）、活产率（72.80% vs. 75.00%，p = 0.948）、剖腹产率（83.90% vs. 77.80%，p = 0.414）相似：结论：早期诊断和治疗 EPs 后，HP 管组和 HIP 组患者的疗效相当。腹腔镜手术和腹腔镜手术治疗HIPs的妊娠结局相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-

CiteScore

4.90

自引率

6.50%

发文量

845

审稿时长

3-8 weeks

期刊介绍： BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.