Dammann Gregory, Murphy Lance, Ellis Julius
Departments of Family Practice and of Obstetrics and Gynecology, Dewitt Army Community Hospital, Fort Belvoir, Virginia, USA.
J Reprod Med. 2002 Mar;47(3):246-8.
Heterotopic pregnancy is a potentially catastrophic form of ectopic pregnancy and is increasing in incidence secondary to assisted reproductive technology. Early diagnosis and intervention are important in avoiding short- and long-term morbidity.
A 36-year-old, nulliparous woman became pregnant by in vitro fertilization and embryo transfer. A total of three embryos were transferred. She presented to the emergency room approximately six weeks after transfer with the complaint of severe abdominal pain. Laboratory analysis revealed a decreasing hematocrit with stable vital signs despite continued abdominal pain. On transvaginal ultrasound, two fetal poles were present, with cardiac activity in two of the three gestational sacs. At surgery the patient was found to have a ruptured tubal pregnancy in addition to the intrauterine gestations. Pathologic analysis revealed a twin tubal pregnancy.
Heterotopic pregnancy should be considered in the differential diagnosis of any patient who becomes pregnant by assisted reproduction techniques and presents with signs and symptoms of ectopic pregnancy.
异位妊娠是一种潜在的灾难性宫外孕形式，其发病率因辅助生殖技术而呈上升趋势。早期诊断和干预对于避免短期和长期发病至关重要。
一名36岁未生育女性通过体外受精和胚胎移植怀孕。共移植了三个胚胎。移植后约六周，她因严重腹痛就诊于急诊室。实验室分析显示血细胞比容下降，尽管持续腹痛但生命体征稳定。经阴道超声检查发现有两个胎芽，三个妊娠囊中两个有心跳。手术时发现患者除子宫内妊娠外，还有输卵管妊娠破裂。病理分析显示为双输卵管妊娠。
对于任何通过辅助生殖技术怀孕并出现宫外孕体征和症状的患者，在鉴别诊断时都应考虑异位妊娠。
