Chen S U, Yang Y S, Ho H N, Ko T M, Hsieh F J, Lee T Y
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1992 Oct;91(10):1002-5.
A case of combined cornual pregnancy and intrauterine twin pregnancy after in vitro fertilization (IVF) and transfer of six embryos is presented. The case was diagnosed as intrauterine triplets ultrasonographically at seven weeks of gestation. Unfortunately, the patient suffered from severe lower abdominal pain and hypovolemic shock at 10 weeks of gestation, and an emergent laparotomy was done. During the operation, a ruptured cornual pregnancy with accompanying hemoperitoneum was found. Because fetal heart beats were not detected by intraoperative ultrasonography in the other two intrauterine fetuses, evacuation of the gestational contents through the uterine defect was done, and the rupture site was repaired. The incidence, mechanism and management of heterotopic pregnancies after in vitro fertilization and embryo transfer are discussed.
本文报告一例体外受精（IVF）并移植6个胚胎后发生的宫角妊娠合并宫内双胎妊娠病例。该病例在妊娠7周时经超声检查诊断为宫内三胎妊娠。不幸的是，患者在妊娠10周时出现严重下腹痛和低血容量性休克，遂行急诊剖腹手术。术中发现宫角妊娠破裂并伴有腹腔内出血。由于术中超声未检测到另外两个宫内胎儿的心跳，故通过子宫缺损处清除妊娠物，并修复破裂部位。文中还讨论了体外受精和胚胎移植后异位妊娠的发生率、机制及处理方法。
