剖宫产瘢痕处妊娠的临床分析

Clinical diagnosis and management of pregnancy on cesarean section scar

目的探讨剖宫产瘢痕处妊娠的临床诊断和治疗方法。方法回顾性分析2008年3月-2010年12月收治的12例子宫下段剖宫产瘢痕处妊娠患者临床资料。结果12例患者停经5。8周后均有无痛性不规则阴道出血，10例患者予米非司酮、甲氨蝶呤药物保守治疗，其中3例在超声监测下行胚囊内辅助局部氨甲喋呤注射，9例患者取得良好结局，1例发生大出血行双侧子宫动脉栓塞。结论彩色多普勒超声检查可用于早期诊断CSP，子宫动脉灌注栓塞术对于CSP是1种安全有效的治疗方法，降低剖宫产率和产后严格避孕是主要的预防办法。

Objective To discuss the characteristics and management of pregnancy on cesarean section sear. clinical manifestations,ultrasonic examination and clinical efficacy of 12cases with scar pregnancy after cesarean section who were treated in the hnspita 1 from Mar.2008 to Dee.2010 were analyzed retrospectively. Results 12 patients stopped after 5 to 8 weeks are painless, irregular vaginal bleeding, 10 patients to mifepristone, methotrexate conservative medical treatment, including three cases in the ultrasound-assisted embryo sac down the local monitoring of methotrexate injection, 9 patients achieved good outcome, 1 case of bleeding underwent bilateral uterine artery embelization. Conclusion Color Doppler ultmsngraphy can be used fo rarly diagnosis o f scar pregnancy after cesarean scction,Super-selective bilateral uterine arterial catheterization and angiography, which is safe and effective in treatment of scar pregnancy after cesarean section.The principle prevention of pregnancy on cesarean section scar is to reduce the cesarean section rate and effective contraception.