{"title":"体外受精/卵胞浆内单精子注射和胚胎移植后异位妊娠的处理:病例系列和微型综述。","authors":"Yang Zhang, Yan Zhai, Danni Qu","doi":"10.2478/abm-2024-0004","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Ectopic pregnancy (EP), reflecting a fertilized ovum implanted outside the normal uterine cavity, represents a frequent cause of morbidity and possibly mortality in women of reproductive age.</p><p><strong>Objective: </strong>To summarize the diagnosis and treatment of EP after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET).</p><p><strong>Methods: </strong>The medical records of patients who were diagnosed with EP after embryo transfer from 2017 to 2019, in a tertiary hospital were reviewed.</p><p><strong>Results: </strong>Of the 24 cases analyzed, 21 (87.5%) had fallopian tube involvement, while 2 (8.3%) and 1 (4.2%) had cornual and cervical pregnancies, respectively. Clinical manifestations included vaginal bleeding (58.3%) and lower abdominal pain (16.7%); 9 (42.9%) cases had no symptoms. One cornual pregnancy was misdiagnosed as acute appendicitis and later correctly diagnosed by laparoscopic exploration. There were 2 cases of multiple-site EP and 2 of heterotopic pregnancy, including one with an intrauterine pregnancy with double chorionic and four amniotic sacs and right tubal ampullary pregnancy. Five of the 21 cases with fallopian tube involvement received conservative treatment, while the remaining 16 underwent surgeries, including laparoscopic ipsilateral salpingostomy and ipsilateral salpingectomy.</p><p><strong>Discussion: </strong>Ectopic pregnancy after embryo transfer, mainly involving the fallopian tube, is very complex and is with diverse manifestations. Even with the pregnancy sac observed in the uterus, the pelvic cavity should be scanned thoroughly after embryo transfer.</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953842/pdf/","citationCount":"0","resultStr":"{\"title\":\"Management of ectopic pregnancy after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer: a case series and mini-review.\",\"authors\":\"Yang Zhang, Yan Zhai, Danni Qu\",\"doi\":\"10.2478/abm-2024-0004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Ectopic pregnancy (EP), reflecting a fertilized ovum implanted outside the normal uterine cavity, represents a frequent cause of morbidity and possibly mortality in women of reproductive age.</p><p><strong>Objective: </strong>To summarize the diagnosis and treatment of EP after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET).</p><p><strong>Methods: </strong>The medical records of patients who were diagnosed with EP after embryo transfer from 2017 to 2019, in a tertiary hospital were reviewed.</p><p><strong>Results: </strong>Of the 24 cases analyzed, 21 (87.5%) had fallopian tube involvement, while 2 (8.3%) and 1 (4.2%) had cornual and cervical pregnancies, respectively. Clinical manifestations included vaginal bleeding (58.3%) and lower abdominal pain (16.7%); 9 (42.9%) cases had no symptoms. One cornual pregnancy was misdiagnosed as acute appendicitis and later correctly diagnosed by laparoscopic exploration. There were 2 cases of multiple-site EP and 2 of heterotopic pregnancy, including one with an intrauterine pregnancy with double chorionic and four amniotic sacs and right tubal ampullary pregnancy. Five of the 21 cases with fallopian tube involvement received conservative treatment, while the remaining 16 underwent surgeries, including laparoscopic ipsilateral salpingostomy and ipsilateral salpingectomy.</p><p><strong>Discussion: </strong>Ectopic pregnancy after embryo transfer, mainly involving the fallopian tube, is very complex and is with diverse manifestations. Even with the pregnancy sac observed in the uterus, the pelvic cavity should be scanned thoroughly after embryo transfer.</p>\",\"PeriodicalId\":8501,\"journal\":{\"name\":\"Asian Biomedicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2024-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953842/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Biomedicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2478/abm-2024-0004\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Biomedicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2478/abm-2024-0004","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:异位妊娠(EP)是指受精卵在正常子宫腔外着床,是育龄妇女发病率和死亡率的一个常见原因:总结体外受精/卵胞浆内单精子注射和胚胎移植(IVF/ICSI-ET)后 EP 的诊断和治疗方法:回顾性分析某三甲医院2017年至2019年胚胎移植后确诊为EP患者的病历:在分析的24例患者中,21例(87.5%)输卵管受累,2例(8.3%)和1例(4.2%)分别为粟粒性妊娠和宫颈妊娠。临床表现包括阴道出血(58.3%)和下腹痛(16.7%);9 例(42.9%)无症状。有一例粟粒性妊娠被误诊为急性阑尾炎,后经腹腔镜探查得到正确诊断。多部位 EP 2 例,异位妊娠 2 例,其中 1 例为双绒毛膜四羊膜囊宫内妊娠和右侧输卵管壶腹部妊娠。21 例输卵管受累病例中有 5 例接受了保守治疗,其余 16 例接受了手术治疗,包括腹腔镜同侧输卵管造口术和同侧输卵管切除术:胚胎移植后异位妊娠主要累及输卵管,情况非常复杂,表现也多种多样。即使在子宫内观察到孕囊,胚胎移植后也应彻底扫描盆腔。
Management of ectopic pregnancy after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer: a case series and mini-review.
Background: Ectopic pregnancy (EP), reflecting a fertilized ovum implanted outside the normal uterine cavity, represents a frequent cause of morbidity and possibly mortality in women of reproductive age.
Objective: To summarize the diagnosis and treatment of EP after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET).
Methods: The medical records of patients who were diagnosed with EP after embryo transfer from 2017 to 2019, in a tertiary hospital were reviewed.
Results: Of the 24 cases analyzed, 21 (87.5%) had fallopian tube involvement, while 2 (8.3%) and 1 (4.2%) had cornual and cervical pregnancies, respectively. Clinical manifestations included vaginal bleeding (58.3%) and lower abdominal pain (16.7%); 9 (42.9%) cases had no symptoms. One cornual pregnancy was misdiagnosed as acute appendicitis and later correctly diagnosed by laparoscopic exploration. There were 2 cases of multiple-site EP and 2 of heterotopic pregnancy, including one with an intrauterine pregnancy with double chorionic and four amniotic sacs and right tubal ampullary pregnancy. Five of the 21 cases with fallopian tube involvement received conservative treatment, while the remaining 16 underwent surgeries, including laparoscopic ipsilateral salpingostomy and ipsilateral salpingectomy.
Discussion: Ectopic pregnancy after embryo transfer, mainly involving the fallopian tube, is very complex and is with diverse manifestations. Even with the pregnancy sac observed in the uterus, the pelvic cavity should be scanned thoroughly after embryo transfer.
期刊介绍:
Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries
Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.