Chang J C, Sun T T, Lin Y C
Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R. O. C.
Changgeng Yi Xue Za Zhi. 1991 Sep;14(3):197-201.
A case of combined intrauterine and tubal ectopic pregnancy is described following in vitro fertilization and the transfer of two four-cell and one two-cell embryos. This phenomenon is known to be related to ovarian stimulation by gonadotropin therapy, and there is an increased risk with tubal disease. Techniques applied at the time of embryo transfer, the use of culture medium with 50% fetal cord serum to convey the embryos to the uterus, the catheterization method, and the position of the patient during transfer are presented. The risk of multiple pregnancies and combined intrauterine and ectopic gestations increases with increasing numbers of transfers and large volume of transfer medium. We would therefore recommend that after IVF-ET treatment in women with tubal disease, intensive care should be taken in the early follow-up period to rule out the possibility of ectopic pregnancy. In this case, a viable ongoing intrauterine pregnancy was confirmed after surgery for right ampullary ectopic pregnancy. And a 2925gm male in excellent condition was delivered by cesarean section without complications.
本文描述了一例体外受精并移植两个四细胞胚胎和一个二细胞胚胎后发生的宫内合并输卵管异位妊娠病例。已知这种现象与促性腺激素治疗引起的卵巢刺激有关，输卵管疾病会增加其风险。文中介绍了胚胎移植时应用的技术、使用含50%胎儿脐带血清的培养基将胚胎输送至子宫的方法、导管插入法以及移植过程中患者的体位。随着移植次数增加和移植培养基体积增大，多胎妊娠以及宫内合并异位妊娠的风险也会增加。因此，我们建议对患有输卵管疾病的女性进行体外受精 - 胚胎移植治疗后，在早期随访阶段应加强护理，以排除异位妊娠的可能性。在该病例中，右侧壶腹部异位妊娠手术后确认了宫内有存活的持续妊娠。随后通过剖宫产顺利产下一名体重2925克、状况良好的男婴，无并发症发生。
