Gong Fei, Cai Sufen, Lu Guangxiu
Reproductive and Stem Cell Institute, Central South University, Changsha 410078, Changsha 410078, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2011 May;36(5):453-6. doi: 10.3969/j.issn.1672-7347.2011.05.014.
To discuss the diagnosis and treatment of jugular vein thrombosis, subclavian vein thrombosis and the right brachiocephalic vein thrombosis after in vitro fertilization and embryo transfer (IVF-ET)cycles in clinical practice. The clinical data regarding a case of jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis in IVF-ET were reviewed. Clinical characteristics, prevention and treatment of jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis in IVF-ET were discussed. A woman with secondary infertility underwent an IVF cycle with prolonged protocol controlled ovarian hyperstimulation. The oestradial concentration was 2 495 pg/mL on the day of human chorionic goeadotrophin (hCG). Fifteen occytes were retrieved and 2 embryos were transferred. Nine days after the embryos were transferred, the patient had ascites,hydrothorax and fluid of pelvic cavity accumulating, and was hospitalized. The patient underwent volume expansion and paracentesis, and left the hospital 30 days after the embryo transfer. Her right neck had pain 43 days after the embryo transfer. B ultrasound showed jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis. The patient underwent low molecular weight heparin anticoagulation and low molecular weight dextran expansion, and left hospital with symptoms improved. She had Caesarean section and had a healthy baby girl. The thrombosis in the IVF-ET was a rare and serious complication. Prevention of ovarian hyperstimulation syndrome (OHSS) may reduce the incidence. The patients had local pain, swelling, skin temperature increased, headache, neck pain, and had to be checked to determine whether there were blood clots. The main treatment was low molecular weight heparin anticoagulation and low molecular weight dextran expansion. Timely Cesarean section is recommended to ensure the safety of perinatal mother and child.
探讨体外受精-胚胎移植（IVF-ET）周期后颈静脉血栓形成、锁骨下静脉血栓形成及右头臂静脉血栓形成在临床实践中的诊断与治疗。回顾了1例IVF-ET后颈静脉血栓形成、锁骨下静脉及右头臂静脉血栓形成的临床资料。讨论了IVF-ET后颈静脉血栓形成、锁骨下静脉及右头臂静脉血栓形成的临床特点、预防及治疗。一名继发性不孕妇女接受了长方案控制性卵巢刺激的IVF周期。人绒毛膜促性腺激素（hCG）日雌二醇浓度为2495 pg/mL。取卵15枚，移植2枚胚胎。胚胎移植后9天，患者出现腹水、胸腔积液及盆腔积液，并住院治疗。患者接受了扩容及腹腔穿刺，胚胎移植后30天出院。胚胎移植后43天，患者右颈部疼痛。B超显示颈静脉血栓形成、锁骨下静脉及右头臂静脉血栓形成。患者接受低分子肝素抗凝及低分子右旋糖酐扩容治疗，症状改善后出院。患者行剖宫产，产下一名健康女婴。IVF-ET中的血栓形成是一种罕见且严重的并发症。预防卵巢过度刺激综合征（OHSS）可能会降低其发生率。患者出现局部疼痛、肿胀、皮肤温度升高、头痛、颈部疼痛，必须进行检查以确定是否有血栓形成。主要治疗方法是低分子肝素抗凝及低分子右旋糖酐扩容。建议适时剖宫产以确保围产期母婴安全。
