辅助生殖技术后异位妊娠发生的类型及危险因素探讨
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摘要
目的探讨辅助生殖技术后异位妊娠发生的类型和危险因素。方法回顾性分析,将2014年6月至2017年6月在上海市第八人民医院妇产科接受辅助生殖技术(ART)后80例异位妊娠(EP)患者作为EP组,并将同期上海市第八人民医院妇产科80例行ART后宫内正常妊娠(IUP)患者作为IUP组,观察输卵管妊娠、宫角妊娠、宫内外同时妊娠及腹腔妊娠等异位妊娠的类型,并对其危险因素给予单因素及多因素Logistic回归分析。结果 80例EP组患者中,69例(86.25%)为输卵管妊娠,5例(6.25%)为宫角妊娠,3例(3.75%)为宫内外同时妊娠;经过单因素Logistic回归分析,与IUP组相比,EP组在继发不孕、既往人工流产史、输卵管手术史以及人绒毛膜促性腺激素(HCG)日子宫内膜厚度方面,差异均具有统计学意义(P<0.05);多因素回归分析显示,ART后异位妊娠发生与继发不孕、输卵管手术史以及HCG日子宫内膜厚度密切相关(P<0.05)。结论 ART后异位妊娠与继发不孕、输卵管手术史、HCG日子宫内膜厚度等因素密切相关,应加强临床关注,给予有效的控制措施。
Objective To investigate the types and risk factors of ectopic pregnancy after assisted reproductive technology. Methods From June 2014 to June 2017,80 patients with ectopic pregnancy( EP) who received assisted reproductive technology( ART) in the obstetrics and gynecology department of Shanghai Eighth People's Hospital were selected as EP group. Eighty People's Hospital of Obstetrics and Gynecology obstetrics and gynecology 80 ART routine intrauterine normal pregnancy( IUP) patients as IUP group,to observe tubal pregnancy,cornual pregnancy,intrauterine and external pregnancy and abdominal pregnancy and other ectopic pregnancy types,and its risk. The factors were given univariate and multivariate logistic regression analysis. Results Among the 80 EP patients,69( 86. 25%) were tubal pregnancies,5( 6. 25%) were horn-angle pregnancies and 3( 3. 75%) were intrauterine and extrauterine pregnancies. After univariate Logistic regression analysis,compared with the EP group,there were significant differences in the history of secondary infertility,previous history of induced abortion,history of tubal surgery,and endometrial thickness of human chorionic gonadotropin( HCG)( P < 0. 05). Multiple factors Regression analysis showed that the occurrence of ectopic pregnancy after ART was closely related to the history of secondary infertility,tubal surgery and endometrial thickness on HCG day( P < 0. 05). Conclusion Ectopic pregnancy after ART is closely related to such factors as secondary infertility,history of tubal surgery and endometrial thickness on HCG day. Clinical attention should be intensified and effective control measures should be given.
Objective To investigate the types and risk factors of ectopic pregnancy after assisted reproductive technology. Methods From June 2014 to June 2017,80 patients with ectopic pregnancy( EP) who received assisted reproductive technology( ART) in the obstetrics and gynecology department of Shanghai Eighth People's Hospital were selected as EP group. Eighty People's Hospital of Obstetrics and Gynecology obstetrics and gynecology 80 ART routine intrauterine normal pregnancy( IUP) patients as IUP group,to observe tubal pregnancy,cornual pregnancy,intrauterine and external pregnancy and abdominal pregnancy and other ectopic pregnancy types,and its risk. The factors were given univariate and multivariate logistic regression analysis. Results Among the 80 EP patients,69( 86. 25%) were tubal pregnancies,5( 6. 25%) were horn-angle pregnancies and 3( 3. 75%) were intrauterine and extrauterine pregnancies. After univariate Logistic regression analysis,compared with the EP group,there were significant differences in the history of secondary infertility,previous history of induced abortion,history of tubal surgery,and endometrial thickness of human chorionic gonadotropin( HCG)( P < 0. 05). Multiple factors Regression analysis showed that the occurrence of ectopic pregnancy after ART was closely related to the history of secondary infertility,tubal surgery and endometrial thickness on HCG day( P < 0. 05). Conclusion Ectopic pregnancy after ART is closely related to such factors as secondary infertility,history of tubal surgery and endometrial thickness on HCG day. Clinical attention should be intensified and effective control measures should be given.
引文
[1]李斌业,吕金春,张永田.原发不育症与继发不育症辅助生殖结局分析[J].临床和实验医学杂志,2017,16(22):2270-2273.
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[9]黄映琴,张波,周红,等.辅助生殖技术中卵巢高反应者行冻融或新鲜单囊胚移植的结局[J].中国计划生育学杂志,2016,24(2):107-110.
[10]康祥锦,丁悦,杨洁,等.不同辅助生殖助孕技术的妊娠结局比较[J].实用医学杂志,2015,31(16):2630-2633.
[11]Tohge T,Zhang Y,Peterek S,et al.Ectopic expression of snapdragon transcription factors facilitates the identification of genes encoding enzymes of anthocyanin decoration in tomato[J].Plant J,2015,83(4):686-704.
[2]王惠,曲绪琴,张倩,等.辅助生殖技术中异位妊娠的发生率及影响因素[J].实用医院临床杂志,2016,13(6):57-59,60.
[3]沈栗帆,何艳,季菲,等.辅助生殖技术妊娠与自然妊娠后发生异位妊娠部位的比较研究[J].新疆医科大学学报,2016,39(12):1512-1514.
[4]冯淑娴,李雪兰,周星宇,等.辅助生殖技术治疗后单卵双胎妊娠的临床分析[J].南方医科大学学报,2016,36(11):1477-1481.
[5]Santos-Ribeiro S,Tournaye H,Polyzos NP.Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK:a 12-year nationwide analysis including 160 000 pregnancies[J].Hum Reprod,2016,31(2):393-402.
[6]郑敏,龙雯晴.辅助生殖技术中非多囊卵巢综合征患者发生卵巢过度刺激综合征的高危因素分析[J].诊断学理论与实践,2016,23(3):287-290.
[7]冉圣元,郁琦,孙爱军,等.体外受精与胚胎移植术后异位妊娠的单中心回顾性研究[J].生殖医学杂志,2017,26(2):158-162.
[8]张园,舒黎,柴德春,等.辅助生殖技术后输卵管间质部妊娠10例临床分析[J].国际生殖健康/计划生育杂志,2015,34(5):372-374.
[9]黄映琴,张波,周红,等.辅助生殖技术中卵巢高反应者行冻融或新鲜单囊胚移植的结局[J].中国计划生育学杂志,2016,24(2):107-110.
[10]康祥锦,丁悦,杨洁,等.不同辅助生殖助孕技术的妊娠结局比较[J].实用医学杂志,2015,31(16):2630-2633.
[11]Tohge T,Zhang Y,Peterek S,et al.Ectopic expression of snapdragon transcription factors facilitates the identification of genes encoding enzymes of anthocyanin decoration in tomato[J].Plant J,2015,83(4):686-704.