Shengluan Tang, Tong Du, Jialyu Huang, Hongjuan Ye, Ming Zhao, Jiaying Lin, Yanping Kuang
{"title":"先前楔形切除间质妊娠对IVF/ICSI冷冻解冻胚胎移植(FET)周期后妊娠和新生儿结局的影响:一项回顾性研究。","authors":"Shengluan Tang, Tong Du, Jialyu Huang, Hongjuan Ye, Ming Zhao, Jiaying Lin, Yanping Kuang","doi":"10.1186/s12958-022-00896-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to evaluate pregnancy and neonatal outcomes in women, with a previous history of wedge resection for interstitial pregnancy, in frozen-thawed embryo transfer (FET) cycles of IVF/ICSI.</p><p><strong>Methods: </strong>The present study involved a retrospective case-control assessment of 75 cases and 375 control subjects over 6 years in a single center. To compare pregnancy and neonatal outcomes between cases, treated using wedge resection, and controls without any previous history of ectopic pregnancy, propensity score matching (1:5) was utilized. The study also compared subgroups in the case group.</p><p><strong>Results: </strong>Women with previous wedge resection exhibited higher rates of ectopic pregnancy and uterine rupture rate as compared to control subjects (9.1% vs 1.3%, P = 0.025 and 4.5% vs 0%, P = 0.035, respectively). No statistically significant differences were recorded between the two cohorts with regard to clinical pregnancy rate, live birth rate, and neonatal outcomes. For pregnancy type subgroup analysis, Z-score and rates of large for gestational age were recorded to be significantly lower in twin pregnancy subgroup when compared with singleton pregnancy subgroup (0.10 (- 0.59, 0.25) vs 0.50 (- 0.97, 1.39), P = 0.005; 4.5% vs 26.1%, P = 0.047, respectively).</p><p><strong>Conclusion: </strong>The results of the present study indicated that previous wedge resection correlated to a higher risk of ectopic pregnancy and uterine rupture. However, it might not be related to an increased risk of adverse neonatal outcomes. The study recommended cesarean section in these patients. Further studies are required to verify the validity of current recommendations.</p>","PeriodicalId":520764,"journal":{"name":"Reproductive biology and endocrinology : RB&E","volume":" ","pages":"23"},"PeriodicalIF":0.0000,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8805226/pdf/","citationCount":"3","resultStr":"{\"title\":\"Effect of previous wedge resection for interstitial pregnancy on pregnancy and neonatal outcomes following frozen-thawed embryo transfer (FET) cycles of IVF/ICSI: a retrospective study.\",\"authors\":\"Shengluan Tang, Tong Du, Jialyu Huang, Hongjuan Ye, Ming Zhao, Jiaying Lin, Yanping Kuang\",\"doi\":\"10.1186/s12958-022-00896-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The present study aimed to evaluate pregnancy and neonatal outcomes in women, with a previous history of wedge resection for interstitial pregnancy, in frozen-thawed embryo transfer (FET) cycles of IVF/ICSI.</p><p><strong>Methods: </strong>The present study involved a retrospective case-control assessment of 75 cases and 375 control subjects over 6 years in a single center. To compare pregnancy and neonatal outcomes between cases, treated using wedge resection, and controls without any previous history of ectopic pregnancy, propensity score matching (1:5) was utilized. The study also compared subgroups in the case group.</p><p><strong>Results: </strong>Women with previous wedge resection exhibited higher rates of ectopic pregnancy and uterine rupture rate as compared to control subjects (9.1% vs 1.3%, P = 0.025 and 4.5% vs 0%, P = 0.035, respectively). No statistically significant differences were recorded between the two cohorts with regard to clinical pregnancy rate, live birth rate, and neonatal outcomes. For pregnancy type subgroup analysis, Z-score and rates of large for gestational age were recorded to be significantly lower in twin pregnancy subgroup when compared with singleton pregnancy subgroup (0.10 (- 0.59, 0.25) vs 0.50 (- 0.97, 1.39), P = 0.005; 4.5% vs 26.1%, P = 0.047, respectively).</p><p><strong>Conclusion: </strong>The results of the present study indicated that previous wedge resection correlated to a higher risk of ectopic pregnancy and uterine rupture. However, it might not be related to an increased risk of adverse neonatal outcomes. The study recommended cesarean section in these patients. Further studies are required to verify the validity of current recommendations.</p>\",\"PeriodicalId\":520764,\"journal\":{\"name\":\"Reproductive biology and endocrinology : RB&E\",\"volume\":\" \",\"pages\":\"23\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8805226/pdf/\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reproductive biology and endocrinology : RB&E\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12958-022-00896-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive biology and endocrinology : RB&E","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12958-022-00896-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3
摘要
目的:本研究旨在评估在IVF/ICSI冷冻解冻胚胎移植(FET)周期中有间质妊娠楔形切除史的妇女的妊娠和新生儿结局。方法:本研究对单个中心的75例病例和375名对照者进行回顾性病例-对照评估,为期6年。为了比较采用楔形切除术的病例和没有任何异位妊娠史的对照组之间的妊娠和新生儿结局,采用倾向评分匹配(1:5)。该研究还比较了病例组中的亚组。结果:与对照组相比,既往行子宫楔形切除术的女性异位妊娠和子宫破裂的发生率分别为9.1%比1.3% (P = 0.025)和4.5%比0% (P = 0.035)。两个队列在临床妊娠率、活产率和新生儿结局方面没有统计学上的显著差异。在妊娠类型亚组分析中,双胎妊娠亚组的z评分和胎龄大发生率显著低于单胎妊娠亚组(0.10 (- 0.59,0.25)vs 0.50 (- 0.97, 1.39), P = 0.005;4.5% vs 26.1%, P = 0.047)。结论:既往子宫楔形切除术与宫外孕及子宫破裂的危险性增高有关。然而,它可能与不良新生儿结局的风险增加无关。该研究建议对这些患者进行剖宫产手术。需要进一步的研究来验证目前建议的有效性。
Effect of previous wedge resection for interstitial pregnancy on pregnancy and neonatal outcomes following frozen-thawed embryo transfer (FET) cycles of IVF/ICSI: a retrospective study.
Objective: The present study aimed to evaluate pregnancy and neonatal outcomes in women, with a previous history of wedge resection for interstitial pregnancy, in frozen-thawed embryo transfer (FET) cycles of IVF/ICSI.
Methods: The present study involved a retrospective case-control assessment of 75 cases and 375 control subjects over 6 years in a single center. To compare pregnancy and neonatal outcomes between cases, treated using wedge resection, and controls without any previous history of ectopic pregnancy, propensity score matching (1:5) was utilized. The study also compared subgroups in the case group.
Results: Women with previous wedge resection exhibited higher rates of ectopic pregnancy and uterine rupture rate as compared to control subjects (9.1% vs 1.3%, P = 0.025 and 4.5% vs 0%, P = 0.035, respectively). No statistically significant differences were recorded between the two cohorts with regard to clinical pregnancy rate, live birth rate, and neonatal outcomes. For pregnancy type subgroup analysis, Z-score and rates of large for gestational age were recorded to be significantly lower in twin pregnancy subgroup when compared with singleton pregnancy subgroup (0.10 (- 0.59, 0.25) vs 0.50 (- 0.97, 1.39), P = 0.005; 4.5% vs 26.1%, P = 0.047, respectively).
Conclusion: The results of the present study indicated that previous wedge resection correlated to a higher risk of ectopic pregnancy and uterine rupture. However, it might not be related to an increased risk of adverse neonatal outcomes. The study recommended cesarean section in these patients. Further studies are required to verify the validity of current recommendations.