子宫疤痕部位妊娠14例临床分析

目的:分析剖宫产术后子宫疤痕部位妊娠病例的临床表现、诊断及治疗经过,以引起临床重视并探讨最佳诊疗方法。方法:回顾性分析我院自2004年11月至2007年6月共收治14例剖宫产术后子宫疤痕部位妊娠患者的诊疗经过。结果:直接确诊6例,误诊8例,误诊率57.14%。保守治疗8例,1例失败中转开腹;直接开腹手术5例,双侧子宫动脉栓塞治疗1例。结论:疤痕子宫妊娠应及早做B超检查,一旦发现子宫疤痕部位妊娠,及时根据患者症状、体征、B超检查结果及血HCG值采取适宜治疗方法。

Clinical Analysis of 14 Ectopic Pregnancy Cases Developing in a Previous Cesarean Scar

Objective:We study the clinical features,diagnosis and treatment of Ectopic Pregnancy developing in a previous cesarean scar to explore the best treatment.Method:A retrospective study was carried out,which analysed clinical process of 14 cases who underwent a previous cesarean scar ectopic pregnancy in our hospital from Nov.2004 to Jun.2007.Result: A rightly diagnosis was made in 6 cases of 14 and a wrong diagnosis was made in the other 8 of 14,the misdiagnose rate was 57.14%.The drug and expectant therapy was performed in 8 patients of 14 and one of them had a following laparotomy for the failure.There were 5 patients of 14 who had undergone laparotomy directly.Uterine artery embolization was performed in only one case of 14.Conclusion:An ectopic pregnancy developing in a previous cesarean scar should be diagnosed by B ultrasound scan as soon as possible.Once diagnosed,a fitting medication should be applied according to the symptom,physical characteristics, B scan and beta-hCG,which is safe and effective.