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目的:观察宫腔镜在体外受精-胚胎移植(IVF-ET)后早期自然流产患者中的诊疗价值与治疗结局。方法:2004年1月至2007年12月期间实施IVF-ET后早期自然流产行宫腔镜检查的患者资料84例,分析其宫腔镜检查结果,对发现的异常宫腔进行治疗,观察再次移植后的妊娠结局。结果:84例中存在宫腔异常58例(69.05%),其中宫腔粘连32例(38.10%),子宫内膜息肉12例(14.29%),子宫内膜炎10例(11.90%),粘膜下子宫肌瘤3例(3.57%),部分性子宫纵隔1例(1.19%)。58例异常宫腔经治疗后于1年内进行再次移植,22例(37.93%)获得临床妊娠,宫外孕2例(3.45%),早期自然流产1例(4.55%),分娩21例。结论:在IVF-ET后发生早期自然流产时应将宫腔镜检查列为首选干预措施,针对异常宫腔治疗后可以改善妊娠结局。
Objective: To observe the diagnosis and treatment value and treatment outcome of hysteroscopy in patients with early spontaneous abortion after in vitro fertilization-embryo transfer (IVF-ET). Methods: From January 2004 to December 2007, 84 cases of hysteroscopy in early spontaneous abortion after IVF-ET were performed. The results of hysteroscopy were analyzed. The abnormal uterine cavity was observed and re-transplantation was observed After the pregnancy outcome. Results: There were 58 cases with abnormal uterine cavity (69.05%) in 84 cases, including 32 cases of intrauterine adhesions (38.10%), 12 cases (14.29%) of endometrial polyps, 10 cases of endometritis (11.90%), The lower uterine fibroids in 3 cases (3.57%), partial uterine mediastinal in 1 case (1.19%). 58 cases of abnormal uterine cavity were transplanted within 1 year after treatment. Clinical pregnancy was obtained in 22 cases (37.93%). Ectopic pregnancy was found in 2 cases (3.45%), early spontaneous abortion in 1 case (4.55%) and childbirth in 21 cases. Conclusion: Hysteroscopy should be the first choice intervention in the early spontaneous abortion after IVF-ET, and the outcome of pregnancy after abnormal uterine cavity treatment can be improved.