Andreeva P, Dimitrov I
Akush Ginekol (Sofiia). 2016;55(4):52-55.
The coexistence of extrauterine and intrauterine or haeterotopic pregnancy (HP) is a rare condition with reported incidence of 1 in 8000 to 1 in 30 000 pregnancies in natural conceived pregnancies, but with the widespread application of assisted reproductive technologies (ART) the incidence of HP in women with ART has risen to about 0.09% to 1.00%. We have reported a case of a 36 old woman, pregnant in 9 gestation week, gravidity 2, 0 para, who have achieved a pregnancy after in-vitro fertilization - embryo-transfer of two freeze embryos, developed after an ICSI procedure with donor eggs. The patient attended our clinic because of acute abdominal pain. She was evaluated by trans-vaginal sonography and coexistence of ectopic tubal and intrauterine pregnancy has been confirmed. Emergency laparoscopy was carried out. Left tubal ectopic pregnancy and hemoperitoneum (1200 ml) were diagnosed. Left salpingectomy was performed. At present, the patient is at 24 gestation week and the pregnancy is developing in a proper manner. We report such a case due to the increase of the awareness to the condition and the possibility of a successful treatment by a laparoscopic surgery. Intrauterine pregnancy does not exclude extrauterine pregnancy especially in cases after in-vitro fertilization.
宫外妊娠与宫内妊娠并存,即异位妊娠(HP),是一种罕见情况,自然受孕妊娠的报道发病率为8000分之一至30000分之一,但随着辅助生殖技术(ART)的广泛应用,接受ART的女性中HP的发病率已升至约0.09%至1.00%。我们报告了一例36岁女性病例,孕9周,孕2产0,通过体外受精 - 胚胎移植两个冷冻胚胎受孕,这两个胚胎是在使用供体卵子的卵胞浆内单精子注射(ICSI)程序后发育而成的。患者因急性腹痛前来我们诊所就诊。经阴道超声检查评估,证实为输卵管异位妊娠与宫内妊娠并存。遂进行了急诊腹腔镜检查。诊断为左侧输卵管异位妊娠和腹腔积血(1200毫升)。实施了左侧输卵管切除术。目前,患者孕24周,妊娠进展正常。我们报告此病例是因为对该病症的认识有所提高,以及腹腔镜手术成功治疗的可能性。宫内妊娠并不排除宫外妊娠,尤其是在体外受精后的病例中。