Clinical characteristics and pregnancy outcome in 185 cases of heterotopic pregnancy
10.3969/j.issn.1672-8467.2024.05.013
- VernacularTitle:185例复合妊娠的临床特征及妊娠结局分析
- Author:
Yang ZHANG
1
;
Yu LU
;
Yun-Zhen YE
;
Xi-Rong XIAO
;
Rui-Xia LI
Author Information
1. 复旦大学附属妇产科医院产科 上海 200011
- Keywords:
heterotopic pregnancy(HP);
rupture;
in vitro fertilization-embryo transfer(IVF-ET);
transvaginal ultrasound examination(TVS)
- From:
Fudan University Journal of Medical Sciences
2024;51(5):736-741,756
- CountryChina
- Language:Chinese
-
Abstract:
Objective To reveal the clinical characteristics of heterotopic pregnancy(HP)and enhance the understanding of its complexity.Methods A retrospective study was conducted among all 390 852 pregnant women who were treated in two tertiary hospitals of obstetrics and gynecology in Shanghai from Jan 2011 to May 2021.We screened and collected patients who were diagnosed as HP,and analyzed their clinical characteristics including menopause time,conception method,location of ectopic pregnancy(EP)and clinical manifestations.Results A total of 185 HP cases enrolled and 14 EP site rupture cases were recognized.Among the 185 cases,84.9%had their EP site in fallopian tube,12.4%were cornual HP.In vitro fertilization-embryo transfer(IVF-ET)ranked first in conception method with rate of 83.8%,followed by ovulation induction with rate of 10.3%and spontaneous conception ranked last with rate of 5.4%.Vaginal bleeding was appeared in 38.4%HP patients,21.1%patients experienced abdominal pain and 12.4%patients had vaginal bleeding complicated by abdominal pain.It is worth mentioning that,25.4%patients had no clinical manifestation.The incidence of EP site rupture was 7.6%.In 14 EP rupture cases,71.4%had abdominal pain as their first clinical manifestation.The post-operation live birth rate of EP site rupture patients was 78.6%,and abortion rate was 14.3%.Conclusion The clinical manifestations of HP are diverse.For patients with vaginal bleeding and abdominal pain,conception method is IVF-ET or ovulation induction,detailed and dynamic transvaginal ultrasound examination should be careful carried out in the uterus and adnexal areas.Patients with abdominal pain should be alert to EP site rupture and early intervention was needed.
