剖宫产瘢痕部位妊娠8例分析

Analysis of 8 Cases of Cesarean Scar Pregnancy

目的探讨剖宫产瘢痕部位妊娠的治疗方法。方法回顾分析重庆市妇产科医院6年来收治的8例剖宫产瘢痕部位妊娠的处理,分析其形成原因、早期诊断、处理方式和结局。结果8例中仅2例早期B超诊断而转院行介入治疗,6例均误诊,排胎过程中大出血,1例切除子宫,3例行剖腹探查行瘢痕部位切除并修补子宫。结论剖宫产瘢痕部位妊娠危险性较大,应严格掌握剖宫产指征。有剖宫产史者早孕流产前应常规彩超检查,警惕剖宫产瘢痕部位妊娠。处理药物治疗首选甲氨喋呤,有子宫破裂者开腹修补为最好的治疗,有大出血风险者可考虑介入治疗。

Objective To explore the treatment on cesarean scar pregnancy （CSP）. Methods 8 cases of CSP in Chongqing Women and Children Health Care Hospital in the past 6 years were retrospected. Causes, early diagnosis, treatment and the results were analyzed. Results Only 2 cases were transferred to other hospitals for intervention treatment due to early diagnosis, while the 6 mistakendiagnosed eases experienced massive haemorrhage during la- bor. Hysterectomy was done in case and transabdominal exploring operation done in 3 cases , with the scar part removed and repaired. Conclusion CSP is dangerous. The guildline for ceaseren section must be strictly obeyed. The early pregnant woman with uterus- cutting history should has routine ultrasonic scan to exclude. MTX is the first choice for medical treatments. Transabdominal exploring operation is the best method for the patient with uterus breaking. Intervention treatment needs to be considered for the patient with the risk of massive haemorrhage.