剖宫产术后子宫切口部位妊娠的临床分析

A Clinical Analysis of Gestation in Caesarean Section scar

目的 探讨剖宫产术后切口部位妊娠的发生原因、诊断及治疗的相关因素。 方法 回顾性分析 1997～2 0 0 3年收治的剖宫产术后切口部位妊娠的 4例患者的临床资料。 结果 4例均有停经后阴道流血 ,其中 3例人流术中大出血 ,术后阴道流血持续不断 ,B超均发现子宫下段前壁有包块。 4例患者中 1例行子宫切除术 ,1例宫腹腔镜联合治疗 ,2例宫颈注射氨甲喋呤 ,待 β -HCG <10 0mIU/ml后行宫腔镜手术。 结论 剖宫产术后切口部位妊娠的早期诊断水平有待提高。药物联合宫腔镜手术治疗该病可获满意效果 ,降低剖宫产率及人工流产率能降低本病的发生。

Objective To analyze the possible reasons,diagnosis and treatment of gestation in caesarean section scar. Methods Analyse the clinical data of four patients with gestation in caesarean section scar retrospectively from 1997 to 2003 . Results All four patients had colporrhagia after menolipsis.Among them,3 cases occurred massive colporrhagia in the process of artificial abortion and continuous bleeding after operation. All of them were detected out masses at the below-anterior segment of uterus by B-ultrasound. 1 patient was treated by hysterectomy,1 received treatment of hystero-laparoscopy,2 cases were treated by injecting methotrexate into the cervix and hysteroscopic operation after β-HCG<100mIU/ml. Conclusion It is necessary to enhance the early diagnosis level of gestation in caesarean section scar. A satisfactory result through can be reached a combination of drugs and hysteroscopy. The incidence of this disease could be lowered following the lower rates of caesarean section and artificial abortion.