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Diagnosis and management of heterotopic intramural pregnancy after in vitro fertilization: an eight-case series.
Cai, Pei; Zheng, Mingxiang; Wang, Qian; Wen, Yi; Chen, Hui; Gong, Fei; Lin, Ge; Li, Xihong; Ouyang, Yan.
Afiliación
  • Cai P; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha City, China.
  • Zheng M; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha City, China.
  • Wang Q; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha City, China.
  • Wen Y; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha City, China.
  • Chen H; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha City, China.
  • Gong F; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha City, China.
  • Lin G; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha City, China.
  • Li X; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha City, China.
  • Ouyang Y; Endoscope center, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha City, China.
Ultraschall Med ; 2024 Aug 26.
Article en En | MEDLINE | ID: mdl-39187241
ABSTRACT

PURPOSE:

To analyze the ultrasound characteristics, clinical management, and pregnancy outcomes of heterotopic intramural pregnancies (HIMPs) after embryo transfer.

METHODS:

This was a retrospective observational study of women who were diagnosed with HIMPs. The ultrasound characteristics, clinical treatment, and pregnancy outcomes of patients with HIMPs were evaluated.

RESULTS:

Eight women with HIMPs were included. Among them, 6 patients were diagnosed by transvaginal sonography, and 2 patients were misdiagnosed with heterotopic interstitial pregnancy. The diagnostic accuracy was 75% (6/8). Five patients with HIMPs were diagnosed at the time of the initial scan (5+6-6+3 weeks). An intramural gestational sac was observed in all 6 patients, and an embryo with cardiac activity was detected in one patient on the follow-up scans. Intrauterine pregnancies (IUPs) were revealed in all 6 patients, and embryo(s) with cardiac activity were observed in 5 patients at the time of the initial diagnosis or later. The patients receiving expectant treatment all presented with bagel signs, while patients with embryos with cardiac activity all underwent surgery. Among the 6 diagnosed women, 1 patient was initially treated medically, 4 were treated expectantly, and 1 was treated surgically. Among the 6 diagnosed patients, the IUPs of 5 patients resulted in live infants.

CONCLUSION:

Single ET should be recommended to decrease the possibility of HIMP. An accurate diagnosis of HIMP was reached in most cases by detailed ultrasound early in the first trimester. Most IUPs of HIMPs seem to have good outcomes with timely and proper management. Expectant management might be a possible choice for nonviable intramural pregnancies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ultraschall Med Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ultraschall Med Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania