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[宫颈异位妊娠的临床特征分析]

[Clinical characteristics analysis of heterotopic cervical pregnancy].

作者信息

Lin M M, Li T M, Ge Y M, Yang S, Yang R, Li R

机构信息

National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Ministry of Education Key Laboratory of Assisted Reproduction (Peking University), Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.

Center for Reproductive Medicine, the First Affiliated Hospital of Hainan Medical University, Haikou 570100, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2024 Sep 3;104(34):3242-3247. doi: 10.3760/cma.j.cn112137-20240516-01125.

Abstract

To investigate the clinical characteristics of heterotopic cervical pregnancy (HCP). A retrospective analysis was conducted based on the general clinical data, assisted reproductive technology (ART) data, diagnosis and treatment data, and pregnancy outcomes of 17 patients diagnosed with HCP who received ART at the Reproductive Medicine Center of Peking University Third Hospital from January 2011 to April 2022. The age of 17 HCP patients was (34.2±1.5) years, all of whom occurred after the application of ART; Among them, 11 cases had a history of uterine cavity operation. All 17 patients had vaginal bleeding, with only 1 case accompanied by abdominal pain. The gestational age at the diagnosis of HCP was [6 (5-6)] weeks. Two patients underwent conservative observation and were closely followed up. Both of them had intrauterine pregnancy until full-term and underwent cesarean section; One patient underwent ultrasound-guided cervical pregnancy reduction surgery, resulting in miscarriage due to premature rupture of membranes at 18 weeks of intrauterine pregnancy; One patient underwent ultrasound-guided cervical pregnancy reduction surgery, followed by uterine artery embolization, hysteroscopy, removal of cervical pregnancy lesions, and curettage due to excessive bleeding; One patient underwent uterine artery embolization, hysteroscopy, cervical pregnancy lesion clearance, and curettage due to excessive vaginal bleeding; One patient underwent hysteroscopy examination, cervical pregnancy lesion removal surgery, and uterine curettage due to embryo arrest during intrauterine pregnancy; 11 cases underwent ultrasound-guided cervical pregnancy lesion clearance surgery, all of which resulted in live births. Among the 13 delivery patients, 4 cases were premature and 9 cases were full-term; 5 cases of vaginal delivery and 8 cases of cesarean section. The most common clinical manifestation of HCP is vaginal bleeding. Ultrasound guided cervical pregnancy lesion clearance surgery is safe and feasible, and with good pregnancy outcomes.

摘要

探讨宫颈异位妊娠(HCP)的临床特征。基于2011年1月至2022年4月在北京大学第三医院生殖医学中心接受辅助生殖技术(ART)治疗的17例诊断为HCP患者的一般临床资料、ART数据、诊断和治疗数据以及妊娠结局进行回顾性分析。17例HCP患者年龄为(34.2±1.5)岁,均在应用ART后发生;其中11例有宫腔手术史。17例患者均有阴道流血,仅1例伴有腹痛。HCP诊断时的孕周为[6(5 - 6)]周。2例患者进行保守观察并密切随访,二者均宫内妊娠至足月并剖宫产;1例患者接受超声引导下宫颈妊娠减灭术,因宫内妊娠18周胎膜早破流产;1例患者接受超声引导下宫颈妊娠减灭术,后因出血过多行子宫动脉栓塞、宫腔镜检查、清除宫颈妊娠病灶及刮宫术;1例患者因阴道流血过多行子宫动脉栓塞、宫腔镜检查、清除宫颈妊娠病灶及刮宫术;1例患者因宫内妊娠胚胎停育行宫腔镜检查、清除宫颈妊娠病灶及刮宫术;11例患者接受超声引导下宫颈妊娠病灶清除术,均分娩活婴。13例分娩患者中,4例早产,9例足月;5例阴道分娩,8例剖宫产。HCP最常见的临床表现为阴道流血。超声引导下宫颈妊娠病灶清除术安全可行,妊娠结局良好。

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