胚胎移植后子宫肌壁间妊娠1例病例并文献复习

The Intramural Ectopic Pregnancy after Embryo Transfer: A Case Report and Literature Review

摘要: 子宫肌壁间妊娠(intramural ectopic pregnancy, IMP)是一种罕见的异位妊娠，即妊娠囊植入子宫肌壁间，未与子宫宫腔相通，并被覆盖肌层组织。其发病率不超过异位妊娠总数的1%。目前对其发病机制仍存在不明确之处，可能的高危因素包括合并既往子宫外伤或手术史、子宫腺肌病或其他相关子宫内膜异位病变疾病、盆腔粘连情况及程度、体外受精–胚胎移植等。其中既往子宫创伤或手术史导致子宫内膜形成内在窦道，包括剖宫产、子宫(腺)肌瘤剔除、刮宫等均可导致其子宫肌壁间妊娠概率增高。本文报道了1例经胚胎移植术后发生子宫肌壁间妊娠的病例，通过结合文献复习对该疾病进行了探讨和分析，阐述了子宫肌壁间妊娠的临床特点和处理方法，对发生子宫肌壁间妊娠的危险因素和术后处理方案得到更深刻的理解。

Abstract: A rare and exclusive form of ectopic pregnancy, intrauterine ectopic pregnancy (IMP), is one in which the gestational sac is implanted between uterine muscle walls, encircled by muscular tissue and not linked to the uterus. Its occurrence rate is less than 1% of all ectopic pregnancies. Its pathogenesis is not clear, and possible high-risk factors include a history of combined previous uterine trauma ortheother surgery, adenomyosis or other related endometriosis diseases, pelvic adhesions and severity, IVF-ET, etc. Previous uterine trauma or surgical history can lead to the formation of an internal sinus in the endometrium, including cesarean section, removal of uterine (glandular) fibroids, curettage, etc., all of which can increase the probability of intramural pregnancy in the uterus. This article reports a case of uterine intramural pregnancy after embryo transfer surgery. A review of literature was conducted to discuss and analyze the disease, with a focus on elaborating on the clinical characteristics and management strategies for uterine intramural pregnancy. The risk factors and postoperative management plans for uterine intramural pregnancy were further understood.