经腹经阴道彩色多普勒超声在诊断及治疗剖宫产术后瘢痕妊娠中的价值

目的探讨经腹经阴道彩色多普勒超声在诊断及治疗剖宫产术后瘢痕妊娠中的价值。方法对经腹部结合经阴道彩色多普勒超声诊断和辅助治疗6例剖宫产术后子宫瘢痕妊娠的资料进行回顾性分析。结果 6例剖宫产后子宫瘢痕妊娠表现为子宫前壁下段剖宫产瘢痕处见妊娠囊、厚壁囊样结构或杂乱回声区。其中,3例治疗成功,1例治疗后复查发现囊样结构变成杂乱回声团,刮宫取样送病理证实;1例外院将宫腔积液误诊为宫内孕行人工流产术,人工流产后出血不止,经保守治疗至HCG降至较低水平,包块逐渐变小;1例外院药流失败行清宫术,经保守治疗无效后,开腹行子宫瘢痕部位妊娠病灶切除加子宫修补术,手术成功。结论经腹结合经阴道彩色多普勒超声能够清晰显示剖宫产后子宫瘢痕妊娠的位置、内部回声及血供情况。

Value of abdominal transvaginal color doppler ultrasound in diagnosis and treatment of cesarean scar pregnancy after cesarean section

Objective To explore the value of abdominal transvaginal color doppler ultrasound in diagnosis and treatment of cesarean scar pregnancy after cesarean section.Methods The data of 6 cases of patients with cesarean scar pregnancy after cesarean section diagnosed and treated by abdominal transvaginal color doppler ultrasound were analyzed retrospectively.Results Six patients with cesarean scar pregnancy after cesarean section showed that uterine antetheca and lower segment that cesarean section scar place had gestational sac,thick wall cystic structure or mixed and disorderly echo area.Among whom 3 cases were successful treatment,1 case reviewed after treatment found that cystic structure changed into mixed and disorderly echo group.sample was selected by uterine curettage and confirmed by pathology;1 case with palace cavity effusion was misdiagnosed as intrauterine pregnancy and underwent artificial abortion in other hospital,bleeding could not be stopped after artificial abortion,after conservative treatment,HCG dropped to a low level,masses gradually became smaller;1 case was treated with uterine curettage after failure of medical abortion,because of invalid conservative treatment,the patient was given pregnancy lesions excision and uterus neoplasty treatment,the operation was successful.Conclusion Abdominal transvaginal color doppler ultrasound can clearly display the position of cesarean scar pregnancy after cesarean section,internal echo and blood supply situation.