国际生殖健康/计划生育杂志 ›› 2026, Vol. 45 ›› Issue (4): 297-301.doi: 10.12280/gjszjk.20260064

• 病例报告 • 上一篇    下一篇

宫内合并宫角妊娠行选择性减胎术一例

陈梦婷, 刘钧彦, 包洪初()   

  1. 261000 山东省潍坊市山东第二医科大学(陈梦婷)青岛大学(刘钧彦); 青岛大学附属烟台毓璜顶医院生殖医学中心(包洪初)
  • 收稿日期:2026-02-04 出版日期:2026-07-15 发布日期:2026-07-27
  • 通讯作者: 包洪初 E-mail:baohongchu@163.com

Selective Reduction for Cornual Heterotopic Pregnancy: A Case Report

CHEN Meng-ting, LIU Jun-yan, BAO Hong-chu()   

  1. Shandong Second Medical University, Weifang 261000, Shandong Province, China (CHEN Meng-ting); Qingdao University, Qingdao 266000, Shandong Province, China (LIU Jun-yan); Reproductive Medicine Center, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, Shandong Province, China (BAO Hong-chu)
  • Received:2026-02-04 Published:2026-07-15 Online:2026-07-27
  • Contact: BAO Hong-chu E-mail:baohongchu@163.com

摘要:

报告1例36岁女性经辅助生殖技术助孕后,确诊为宫腔内与右侧宫角部复合妊娠(双绒毛膜双羊膜囊双胎),于妊娠10+4周行经阴道超声引导下右侧宫角妊娠选择性减胎术,成功减灭宫角部位胎儿,宫腔内正常胚胎持续健康发育,于妊娠35+2周行剖宫产顺利分娩,母婴结局良好。胚胎移植术后宫内合并宫角妊娠临床罕见,因宫角肌层薄弱,妊娠中晚期破裂出血风险高,治疗难度大。此类患者诊疗中需尽早明确诊断,优先保障宫内正常妊娠安全,避免盲目清宫或过度干预。同时提示,在临床辅助生殖技术助孕治疗中,优先推荐单胚胎移植,可有效降低此类高危复合妊娠的发生风险。

关键词: 妊娠,宫角, 复合妊娠, 妊娠减少,多胎, 生殖技术,辅助, 超声检查

Abstract:

A 36-year-old woman, who conceived via assisted reproductive technology, was diagnosed with heterotopic pregnancy involving intrauterine and right cornual pregnancy (dichorionic diamniotic twins). Selective reduction of the right cornual pregnancy was performed under transvaginal ultrasound guidance at 10+4 weeks of gestation. The cornual fetus was successfully selectively reduced, while the intrauterine embryo continued to develop normally. The patient delivered a live infant by cesarean section at 35+2 weeks of gestation, with a favorable maternal and neonatal outcomes. Cornual heterotopic pregnancy after embryo transfer is clinically rare. Due to the thin myometrium at the cornual region, the risk of rupture and hemorrhage is high in the second and third trimesters, making management challenging. Early and accurate diagnosis is essential for such patients, with priority given to protecting the intrauterine pregnancy and avoiding blind curettage or excessive intervention. Meanwhile, this case indicates that single embryo transfer is strongly recommended in assisted reproductive technology to effectively reduce the risk of such high-risk heterotopic pregnancies.

Key words: Pregnancy, cornual, Heterotopic pregnancy, Pregnancy reduction, multifetal, Reproductive techniques, assisted, Ultrasonography