子宫下段疤痕处早期妊娠的临床诊断及治疗分析

目的:分析25例确诊为剖宫产术后疤痕早期妊娠病例的临床表现、诊断及治疗。方法:采用甲氨蝶呤(MTX)联合米非司酮药物治疗,MTX于超声引导下孕囊内注射,米非司酮口服治疗。结果:20例药物治疗成功,5例行髂内动脉栓塞成功,1例最终行全子宫切除术。结论:子宫下段疤痕妊娠应尽早做B超检查明确诊断,采用MTX联合米非司酮药物治疗子宫下段疤痕妊娠是一种安全有效的方法,必要时介入治疗也可作为保留子宫的可选方法之一。

Diagnosis and treatment of the pregnancy at uterine scar caused by previous cesarean section

Objective:To explore the clinical presentation,diagnosis and treatment of 25 cases of cesarean scar pregnancy.Methods:Treatment measures included local MTX ultrasound-guided injection in gestational sac and oral mifepristone in 25 cases.Results:Among 25 cases,medical therapy performed successfully in 20 cases,routine internal iliac artery embolized successfully in 5 cases,which failed in one who had hysterectomy later.Conclusion:Cesarean scar pregnancy should be diagnosed by ultrasound in the early stage.Once such pregnancy is diagnosed,medication by MTX with mifepristone should be applied as the first approach,which is safe and effective,and interventional therapy could be one of the elective methods to reserve the uterine.