Clinical Analysis Of Heterotopic Pregnancy After IVF-ET

Part 1Management strategies of heterotopic pregnancy following in vitro fertilization-embryo transferObjective:To evaluate the efficency and safety of different treatment modality of heterotopic pregnancy(HP)in vitro fertilisation-embryo transfer(IVF-ET)cycles,to avoid the influence on the intrauterine pregnancy(IUP).Design:A retrospective cohortSetting:Reproductive Hospital Affiliated to Shandong University.Patient(s):Women who diagnosed of HP from the IVF/ICSI registry databaseIntervention(s):IVF/ICSI-ET,surgical treatment or expectant management.Main Outcome Measure(s):Comparative study of the diagnosis and treatment of heterotopic pregnancy.Result(s):Our result showed the surgical treatment had a certain effect on improving the live birth rate of patients,though there was no statistically significant(87.9%vs.70.8%,P=0.055).The risk factors for HP included previous tubal surgery and hydrosalpinx.And after 14 days of embryo transfer,the serum levels of β-human chorionic gonadotropin(β-HCG),and Estradiol(E2)were lower in HP group compared to intrauterine pregnancy(P<0.05,respectively).Furthermore,between the early abortion and the live birth groups of HP,age and endometrial thickness had a significant difference.Conclusion(s):In our retrospective study,we supported early surgical laparoscopic intervention can minimize the incidence of abortion of IUP and resulte in a better live birth rate The history of ectopic pregnancy history and previous tubal surgery may increase the risk of HP.Low levels of serum β-hCG and E2 on the 14th day after embryo transfer could indicate the incidence of HPPart 2Clinical observation of laparoscopic heterotopic pregnancy with intrauterine hemorrhageObjective:To evaluate the efficacy of laparoscopic surgery in the treatment of heterotopic pregnancy(HP)with uterine hemorrhage.Methods:The clinical data of 3 patients diagnosed as heterotopic pregnancy with intrauterine hemorrhage in Center for Reproductive Medicine,Provincial Hospital Affiliated to Shandong University were retrospectively analyzed.All patients underwent laparoscopic surgery to remove ectopic pregnancy(EP)tissue.Results:The study of intraoperative blood loss,hospital stay and daily life recovery time were ideal.There was no persistent ectopic pregnancy occurred after surgery.The follow-up study of postoperative B-ultrasound showed that the symptoms of uterine hemorrhage gradually disappeared to disappear in 3 patients.The patients with pregnancy outcomes were all full-term,and we proved laparoscopic treatment was successful in heterotopic pregnancy with intrauterine hemorrhage.Conclusion:heterotopic pregnancy is rare.If combined with intrauterine hemorrhage,it will adversely affect the growth and development of intrauterine pregnancy.Laparoscopic surgery is a safe and effective surgical method.Early diagnosis and timely surgical treatment can effectively reduce the risk and improve the clinical treatment effect.