Yang Peiwen, Shen Lin, Ai Jihui, Zhao Yiqing
Reproductive Medicine Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Med (Lausanne). 2023 Aug 22;10:1234425. doi: 10.3389/fmed.2023.1234425. eCollection 2023.
Currently, the treatment strategies for angular pregnancy in the first trimester after assisted reproduction technology (ART) are unclear. Improper treatment will cause unnecessary losses to patients, especially infertile patients, after ART. The purpose of this study was to clarify the pregnancy outcomes of expectant treatment for angular pregnancy post-ART and to provide a basis for the formulation of clinical treatment strategies.
This retrospective case series study was performed at the Reproductive Medicine Center of a university hospital. Maternal data and pregnancy outcomes were collected and analyzed for all patients diagnosed with angular pregnancies after ART between January 2016 and August 2021. The outcomes included live birth, term birth, premature birth, early pregnancy loss, fetal death, placental abruption, uterine rupture, maternal death, and hysterectomy.
A total of 78 patients were analyzed in this study, of whom 54 (69.2%) had live births, 44 (56.4%) had term births, 21 (26.9%) had an early pregnancy loss, 1 (1.3%) had mid-trimester missed abortion, 1 (1.3%) underwent mid-trimester labor induction due to fetal malformation, and 1 (1.3%) underwent uterine rupture. There were no cases of maternal death, placental abruption, or hysterectomies.
Angular pregnancy after ART is not as dangerous as that described in previous studies; most cases could be treated expectantly under close-interval follow-up and obtain live birth.
目前，辅助生殖技术（ART）后孕早期子宫角部妊娠的治疗策略尚不明确。不当的治疗会给ART后的患者，尤其是不孕患者带来不必要的损失。本研究的目的是阐明ART后子宫角部妊娠期待治疗的妊娠结局，并为临床治疗策略的制定提供依据。
本回顾性病例系列研究在一所大学医院的生殖医学中心进行。收集并分析了2016年1月至2021年8月期间所有诊断为ART后子宫角部妊娠患者的母亲数据和妊娠结局。结局包括活产、足月产、早产、早期妊娠丢失、胎儿死亡、胎盘早剥、子宫破裂、孕产妇死亡和子宫切除术。
本研究共分析了78例患者，其中54例（69.2%）活产，44例（56.4%）足月产，21例（26.9%）早期妊娠丢失，1例（1.3%）孕中期稽留流产，1例（1.3%）因胎儿畸形在孕中期引产，1例（1.3%）发生子宫破裂。无孕产妇死亡、胎盘早剥或子宫切除术病例。
ART后的子宫角部妊娠并不像先前研究中描述的那样危险；大多数病例在密切随访下可进行期待治疗并获得活产。
