经阴道彩色多普勒超声在剖宫产后瘢痕处妊娠的诊断价值

目的 探讨经阴道彩色多普勒超声检查在诊断剖宫产后瘢痕处妊娠的临床价值.方法 对云南省第二人民医院2006年6月至2011年6月间诊断为剖宫产后瘢痕处妊娠的27例患者的声像图及临床处理进行回顾性分析.结果 (1) 27例患者中,胚囊型18例,混合型7例,部分宫腔型2例.26例明确诊断,1例误诊,诊断符合率96.4％； (2)根据孕囊或团块与肌层的关系分3级.1级14例全部保守治疗成功；2级11例,其中8例保守治疗成功,3例保守治疗无效后行子宫修补术；3级2例,均行子宫修补术.结论 经阴道彩色多普勒超声检查是剖宫产后瘢痕处妊娠的最佳检查方法之一.孕囊或包块与肌层的分级关系、血供情况能够指导临床选择治疗方法.

Diagnostic Value of Transvaginal Colour Doppler Ultrasonic Examination for Cesarean Scar Pregancy

Objective To explore the clinical value of transvaginal ultrasonic on cesarean scar pregnancy.Method The transvaginal ultrasound imaging of 27 patients with cesarean scar pregnancy and their clinical treatments(2006 to 2011) were retrospectively analyzed.Result(1) All cases were verified by clinical and pathologic results,including 18 with gastrula type,7 with commix mass type and 2 with uterine cavity type.26 cases were correcty diagnosed by ultrasound and there was 1 case of misdiagnosis,with the correct diagnosis rate of 96.4%;(2) We classified all cases into 3 grades according to the relationship between the gestational sac or mass and the myometrum.14 case in grade1 were successfully treated by expertant treatment.Out of 11 cases in grade 2,8 cases were successfully treated by expectant treatment and the other cases were treated by uterus neoplasty.2 cases in grade 3 were treated by uterus neoplasty.Conclusions Transvaginal color Doppler ultrasound is one of the best methods for the diagnosis of the pregnancy in the uterine scar of previous caesarean section.The relationship between the gestational sac or mass and the myometrium in the ultrasound imaging,and the results of color dopplor benefit the proper choice of clinical treatment.