国际妇产科学杂志 ›› 2019, Vol. 46 ›› Issue (4): 437-439.

• 病例报告 • 上一篇    下一篇

体外受精-胚胎移植后宫内妊娠合并瘢痕妊娠一例

李慧苓,范丽梅   

  1. 130000 长春,吉林大学第二医院
  • 收稿日期:2018-12-21 修回日期:2019-03-25 出版日期:2019-08-15 发布日期:2019-08-15
  • 通讯作者: 范丽梅,E-mail:fanlimei1971@126.com E-mail:fanlimei1971@162.com

Concurrent Intrauterine and Uterine Caesarean Scar Pregnancy after IVF-ET:A Case Report

LI Hui-ling,FAN Li-mei   

  1. The Second Hospital of Jilin University,Changchun 130000,China
  • Received:2018-12-21 Revised:2019-03-25 Published:2019-08-15 Online:2019-08-15
  • Contact: FAN Li-mei,E-mail:fanlimei1971@126.com E-mail:fanlimei1971@162.com

摘要: 报道1例体外受精-胚胎移植(IVF-ET)后宫内妊娠合并子宫瘢痕妊娠(CSP)的病例。该患者取卵3枚,成功配成3枚胚胎,移植胚胎3枚,成功着床2枚,但1枚在宫内正常位置上,1枚着床在前次剖宫产切口上。该患者对瘢痕处的妊娠囊行减胎术后,因持续不规则阴道出血来医院就诊,妇科超声检查提示,宫腔内可见2个胎囊,其一可见胎芽,胎心(+),其二位于前次剖宫产切口处,仅见胎囊,其内未见卵黄囊及胎芽,形态不规则。最终行经腹宫腔内胎盘胎儿清除术+CSP病灶切除术+剖宫产瘢痕憩室修补术,终止妊娠。报道此特殊病例,将CSP的超声和磁共振成像(MRI)诊断技术的优缺点进行比较,并对CSP的治疗和预防提出一些思考。

关键词: 子宫, 瘢痕, 受精, 体外, 胚胎移植, 妊娠, 异位, 妊娠减少, 多胎, 子宫瘢痕妊娠

Abstract: bryos were successfully matched. 3 embryos were transplanted and 2 of them were successfully implanted, but one was implanted at the normal position in the uterus, and the other was implanted at the scar position of the previous cesarean section. The patient was treated with the reduction of the gestation sac at the scar position. Then the patient came to the hospital for treatment because of irregular vaginal bleeding. The gynecological ultrasonography showed that there were 2 fetal sacs in the uterine cavity. The fetal bud and fetal heart of one fetal sac could be seen; the other fetal sac was located at the scar position of the previous cesarean section, and only the fetal sac of irregular shape could be seen while the yolk sac or fetal bud could not be seen. Finally, the fetus was removed by intra-abdominal placenta removal + CSP lesionectomy+ cesarean section scar diverticulum neoplasty, and the pregnancy was terminated. This particular case was reported to compare the advantages and disadvantages of ultrasonography and magnetic resonance imaging (MRI) for diagnosing CSP. Some thoughts on the treatment and prevention of CSP were provided.

Key words: Uterus, Cicatrix, Fertilization in vitro, Embryo transfer, Pregnancy, ectopic, Pregnancy reduction, multifetal, Cesarean scar pregnancy