一例罕见的异位五胞胎妊娠。

A rare case of heterotopic quintuplets pregnancy.

机构信息

Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Department of Obstetrics and Gynaecology, Sabah Women's and Children's Hospital, Sabah, Malaysia.

出版信息

Taiwan J Obstet Gynecol. 2019 Sep;58(5):684-687. doi: 10.1016/j.tjog.2019.07.018.

DOI:10.1016/j.tjog.2019.07.018

PMID:31542093

Abstract

OBJECTIVE

We report a rare case of heterotopic pregnancy and high-order pregnancy occurring simultaneously following the use of the assisted reproductive technique (ART).

CASE REPORT

A 29-year-old woman, Gravida 2 Para 1, became pregnant after receiving intrauterine insemination (IUI). She came to our emergency room due to diffuse low abdominal pain at seven weeks of gestational age. Transabdominal sonography (TAS) revealed a quadruplet intrauterine pregnancy with an enlarged left adnexa and intrapelvic fluid accumulation. Simultaneous occurrence of high-order pregnancy and left tubal pregnancy with internal hemorrhage was suspected. The patient received an emergent laparoscopic resection of the affected Fallopian tube and recovered well for the remaining hospitalization course. Afterwards, she received fetal reduction procedure and eventually gave birth to twin babies.

CONCLUSION

Gynecologist should increase the awareness of heterotopic pregnancy in patients receiving ART. On the other hand, reproductive endocrinologist should reduce the risk of high-order pregnancy without compromising pregnancy rate.

摘要

目的

我们报告了一例罕见的异位妊娠和多胎妊娠病例，这些病例是在使用辅助生殖技术（ART）后同时发生的。

病例报告

一名 29 岁妇女，孕 2 产 1，在接受宫腔内人工授精（IUI）后怀孕。她在妊娠 7 周时因弥漫性下腹疼痛来到我们的急诊室。经腹超声（TAS）显示四胞胎宫内妊娠，左侧附件增大，盆腔内积液积聚。疑似同时发生多胎妊娠和左侧输卵管妊娠伴内出血。患者接受紧急腹腔镜切除受累输卵管，其余住院期间恢复良好。之后，她接受了胎儿减少手术，最终生下了一对双胞胎。