剖宫产瘢痕妊娠期待治疗的利与弊

剖宫产瘢痕妊娠（cesarean scar pregnancy，CSP）是指受精卵着床于前次剖宫产子宫切口瘢痕处的一种特殊类型的异位妊娠。具有限时性，早孕期为异位妊娠，中晚孕则发展为宫内中孕，胎盘植入或凶险性前置胎盘，并发症发生率高，有大出血、子宫破裂甚至子宫切除的风险。处理原则：应该早诊断、早终止、早清除。终止的方法尚无标准。目前为药物治疗，手术治疗或子宫动脉栓塞或者两者的联合。药物等保守治疗具有一定的局限性，失败率高，耗时长等特点不建议首选。

Advantages and disadvantages of the expectant treatment for cesarean scar pregnancy.

Cesarean scar pregnancy is a special kinds of ectopic pregnancy in which the embryo implants in the iatrgentic cesarean scar left in the uterus.This ectopic pregnancy definition is time-limit，for as the pregnancy goes on to the second or third trimester，the fetus will grow up into the cavity of uterus，the placenta implanting into the cesearean scar or complicating with placenta precia.This special pregnancy may have the high risk of severe complications，such as heavy homeorrhage，uterus rupture，and emergency hysterectomy.Therefore，the basic rules of treatment should be to diagnose and terminate it as early as possible.There is no standard treatment.At present，the therapeutic methods include medicine，surgery，uterine artery embolism or the combination of all.The medical treatment has some limits，and it will take a long time to recover and is with high rate of failure，so it is not recommended as the first line therapy for CSP.