剖宫产瘢痕妊娠41例临床分析

目的探讨剖宫产瘢痕妊娠的发病机制、早期诊断以及治疗方法。方法回顾分析41例剖宫产瘢痕妊娠患者的临床资料,包括患者的发病年龄,孕次及产次,剖宫产手术史及发病至剖宫产术的间隔时间,首发症状及辅助检查的结果,治疗方法及结局。结果 41例患者中2例自然流产,39例患者行双侧子宫动脉化疗栓塞术,32例患者因β-HCG下降不满意或超声提示剖宫产切口瘢痕处仍有妊娠组织或异常团块而行清宫术。结论随着剖宫产瘢痕妊娠病例增多,为避免其引起严重的并发症,早期诊断并作出正确的治疗至关重要。CSP的治疗尚无统一的标准,子宫动脉化疗栓塞术是非常安全、有效的选择。

Clinical analysis on 41 cases of cesarean scar pregnancy

Objective To explore the pathogenesis, early diagnosis and individualized treatment of cesarean scar pregnancy. Methods The clinical data of 41 patients with cesarean scar pregnancy were analyzed retrospectively, including age of onset, gestational weeks, interval time from the last cesarean delivery to diagnosis, the first symptom, location of the disease, the process of diagnosis and treatment, individualized treatment andoutcomes. Results Uterine artery chemoembolization was performed in 39 patients with cesarean section scar pregnancy. Via bilateral uterine arteries 80 mg MTX were infused separately, which was followed by the embolization of bilateral uterine arteries. The success rate of bilateral uterine artery chemoembolization was 100%. Conclusion The early diagnosis should be made for the patients with cesarean delivery history. The uterine artery chemoembolization is an effective and safe treatment for cesarean section scar pregnancy.