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体外受精-胚胎移植术后剖宫产瘢痕部位妊娠合并宫内妊娠的成功管理。

Successful management of heterotopic cesarean scar pregnancy combined with intrauterine pregnancy after in vitro fertilization-embryo transfer.

作者信息

Wang Chao-Nin, Chen Chun-Kai, Wang Hsin-Shih, Chiueh Ho-Yen, Soong Yung-Kuei

机构信息

Department of Obstetrics and Gynecology, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.

出版信息

Fertil Steril. 2007 Sep;88(3):706.e13-6. doi: 10.1016/j.fertnstert.2006.11.192. Epub 2007 Aug 6.

Abstract

OBJECTIVE

To present a case of cesarean scar pregnancy combined with intrauterine pregnancy after IVF-embryo transfer. Successful embryo reduction was performed and preserved the normal intrauterine gestation.

DESIGN

Case report.

SETTING

Tertiary referral case center.

PATIENT(S): A woman with cesarean scar pregnancy combined with intrauterine pregnancy after IVF-embryo transfer.

INTERVENTION(S): Early diagnosis of heterotopic cesarean scar pregnancy and selective embryo reduction was performed by ultrasound-guided potassium chloride (KCl) directed injection.

MAIN OUTCOME MEASURE(S): Successful pregnancy outcome.

RESULT(S): A 38-year-old woman achieve pregnancy by IVF-embryo transfer. Heterotopic cesarean scar pregnancy was diagnosed at 7 weeks gestational age. A transvaginal ultrasound-guided KCl injection was given to terminate the cesarean scar embryo and a healthy infant was delivered 6 months later.

CONCLUSION(S): Heterotopic cesarean scar pregnancy after IVF is extremely rare. Transvaginal intracardiac injection of KCl is a safe and reliable method to terminate the cesarean scar pregnancy. Satisfactory pregnancy outcome should be achieved.

摘要

目的

介绍一例体外受精-胚胎移植后剖宫产瘢痕妊娠合并宫内妊娠的病例。成功实施了胚胎减灭术并保留了正常的宫内妊娠。

设计

病例报告。

单位

三级转诊病例中心。

患者

一名体外受精-胚胎移植后剖宫产瘢痕妊娠合并宫内妊娠的女性。

干预措施

通过超声引导下向氯化钾(KCl)注射进行剖宫产瘢痕异位妊娠的早期诊断和选择性胚胎减灭术。

主要观察指标

成功的妊娠结局。

结果

一名38岁女性通过体外受精-胚胎移植受孕。孕7周时诊断为剖宫产瘢痕异位妊娠。经阴道超声引导下注射氯化钾以终止剖宫产瘢痕处的胚胎,6个月后分娩出一名健康婴儿。

结论

体外受精后剖宫产瘢痕异位妊娠极为罕见。经阴道心内注射氯化钾是终止剖宫产瘢痕妊娠的一种安全可靠的方法。应实现满意的妊娠结局。

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