Abstract
To evaluate the effects of laparoscopic surgery under general anesthesia on pregnancy outcomes of patients with heterotopic pregnancy (HP) following in vitro fertilization-embryo transfer (IVF-ET). This retrospective study reviewed 24 patients with HP following IVF-ET between January 2018 and August 2020. The patients had been divided into two groups according to whether fetal heart activities were detected by ultrasound preoperatively in intrauterine pregnancy (IUP) at diagnosis. General characteristics, clinical characteristics, pregnancy outcomes were compared between the group with heart activity in IUP (18cases) and the group without heart activity in IUP (6 cases). The general and clinical characteristics were comparable except previous ectopic pregnancy history and fetal status in IUP after surgery between two groups. The rate of previous ectopic pregnancy in group with heart activity in IUP was 33.3% versus 0 in group without heart activity in IUP (p=0.04). Postoperative transvaginal ultrasound (TVS) scans had confirmed that four cases were not able to continue intrauterine pregnancies: 1 patient (16.7%) with heart activity in IUP versus 3 patients (50.0%) without heart activity in IUP, the difference was statistically significant (P=0.02). Among the 20 patients who were able to continue intrauterine pregnancy after surgery, the live birth rate, miscarriage rate, premature birth rate, term birth rate, cesarean section rate, male rate, low birth weight infant rate of the group with heart activity in IUP were 88.2%, 11.8%, 17.6%, 70.6%, 93.3%, 53.3%, 20.0%, which were 66.7%, 33.3%, 0, 66.7%, 100%, 100%, 0 in the group without heart activity in IUP respectively, there were no significant differences between the two groups (P>0.05). Among the neonates, one premature neonate was diagnosed with Pilot type sequence sign at birth, and the rest neonates had no birth defects. Laparoscopic surgery under general anesthesia in early pregnancy was safe for HP patients. Early diagnosis and timely surgical treatment may lead to favorable pregnancy outcomes, especially for the patients with heart activity in IUP.
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