剖宫产后早期妊娠并发症的彩色多普勒超声探查价值

Diagnosis value of color Doppler ultrasound in scarring pregnancy and cervical pregnancy after cesarean section

目的探讨孕早期剖宫产术后瘢痕子宫再妊娠并发症声像图特征,评价常规彩色多普勒超声在诊断、治疗该类并发症中的临床价值。方法回顾性分析经手术或病理证实孕早期发生剖宫产术后并发症患者48例声像图特征。结果 48例剖宫产后妊娠患者中,手术瘢痕妊娠(CSP)23例,子宫颈妊娠(CP)25例;43例妊娠物内部及周边均探及高速动、静脉血流信号,9例CSP探及动静脉瘘样血流频谱,6例CSP探及假性动脉瘤样血流频谱。6例CSP、5例CP经甲氨蝶呤和(或)米非司酮治疗,妊娠物血流明显减少、阻力显著增加后被顺利清出。结论彩色多普勒超声在临床诊治孕早期剖宫产后并发症具有重要临床意义,可以作为诊治该类远期并发症的常规检查手段。

Objective To explore the ultrasonographic characteristics of scarring pregnancy and cervical pregnancy after cesarean section, to evaluate the clinic value of color Doppler ultrasound in diagnosis and treatment of scarring pregnancy and cervical pregnancy. Methods We retrospectively analyzed the uhrasonographic characteristics confirmed by operation or pathological examination. Results In 48 patients there were 23 cases of cesarean scar pregnancy （CSP） and 25 cases of cervicalpregnanc （CP）. High-speed arteries and veins blood flow signs were detected in both internal and peripheral of 43 pregnant patients underwent color Doppler ultrasound examination. Artery vein flow spectrum was detected around pregnant object in 9 cases of CSP, false aneurysm spectrum were detected around pregnant object in 6 cases patients of CSP. Six cases of CSP and 5 cases of CP were treated with methotrexate plus mifepristone or either alone, blood flow of pregnant object was decreased, and the object was smoothly passed out of the body by increase of resistance. Color Doppler ultrasound can be used to diagnosis and treat of scarring pregnancy and cervical pregnancy after cesarean section, and it can be used as a routine examination method to diagnose and treat such complications.