Surgical treatment of fallopian tubal pregnancy and interstitial pregnancy has no differential effect on intrauterine pregnancy after in vitro fertilization-embryo transfer.

Autor: Zheng M; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China.; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China., Peng Y; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China.; Department of Science and Research, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China., Cai P; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China.; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China., He Q; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China.; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China., Fei G; Reproductive Center, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China.; NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha, Hunan Province, 410078, China., Hui C; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China.; Endoscope Center, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China., Mao Y; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China.; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China., Li X; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China. xihongliyxk@163.com.; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China. xihongliyxk@163.com., Ouyang Y; Imaging Department, Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, Hunan Province, 410078, China. 148323942@qq.com.; Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, Hunan Province, 410078, China. 148323942@qq.com.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2024 Nov 18; Vol. 24 (1), pp. 762. Date of Electronic Publication: 2024 Nov 18.
DOI: 10.1186/s12884-024-06943-9
Abstrakt: Background: Due to the specific nature of interstitial pregnancy (IP), there are significant risks to both the mother and the foetus in women with a heterotopic interstitial pregnancy (HIP). IP alone has been analysed as a site-specific ectopic pregnancy (EP) in previous studies; however, according to the latest European Society of Human Reproduction and Embryology criteria, IP is classified as a tubal pregnancy. If IP can be classified as a tubal pregnancy, then there is no difference in the effects of these two methods on intrauterine pregnancies (IUPs). Under the premise of timely surgery, disposing of IPs and tubal pregnancy (excluding IPs) should also have no differential effect on IUPs.
Methods: Patients with heterotopic fallopian tubal pregnancy (HP-tube) and HIP seen at our hospital from January 2005 to December 2020 were included. All included patients were diagnosed by transvaginal sonography (TVS), and EPs were confirmed by surgery and pathological analysis. The IUP outcomes after surgical treatment of the EPs were compared between the HP-tube group (n = 464) and the HIP group (n = 206). The outcomes of IUPs were evaluated in patients with HIP who underwent either laparoscopy (169 cases) or laparotomy (36 cases).
Results: There was no significant difference in postoperative miscarriage (6.90% vs. 6.80%, odds ratio (OR) = 1.859, 95% confidence interval (CI) (0.807-4.279), p = 0.145); early spontaneous miscarriage (19.61% vs. 18.93%, OR = 0.788, 95% CI (0.495-1.255), p = 0.316); or late miscarriage (0.43% vs. 0.49%, OR = 0.823, 95% CI (0.070-9.661), p = 0.877) between the HP-tube group and the HIP group. There was no significant difference between the two groups in terms of preterm birth (7.33% vs. 6.80%, OR = 1.044, 95% CI (0.509-2.139), p = 0.907), live birth rate (71.60% vs. 73.30%, OR = 1.010, 95% CI (0.670-1.530), p = 0.980), or perinatal mortality rate (2.00% vs. 0.65%, OR = 0.580, 95% CI (0.030-3.590), p = 0.620). Compared to laparotomy for HIPs, laparoscopic treatment was associated with similar rates of postoperative miscarriage (5.33% vs. 13.90%, p = 0.076), live birth rate (72.80% vs. 75.00%, p = 0.948), caesarean Sect. (83.90% vs. 77.80%, p = 0.414).
Conclusions: After early diagnosis and treatment of EPs, patients in the HP-tube and HIP groups achieved comparable outcomes. Laparotomy and laparoscopy for treating HIPs yielded similar pregnancy outcomes.
Competing Interests: Declarations Ethics approval and consent to participate This study was approved by the Ethics Committee of CITIC Xiangya Reproductive and Genetic Hospital (Changsha, People’s Republic of China, LL-SC-2023-016). All methods were carried out in accordance with relevant guidelines and regulations, such as the Declaration of Helsinki. The need for informed consent was waived by the Ethics Committee of CITIC Xiangya Reproductive and Genetic Hospital because of the retrospective nature of the study. Consent for Publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje