剖宫产术后子宫瘢痕妊娠的临床诊治新进展

New progress in clinical diagnosis and treatment of uterine scar pregnancy after cesarean section

当前随着医学技术,特别是剖宫产技术、分娩技术与麻醉技术的提高,使得剖宫产的安全性与有效性得到了明显提高,有效提高了孕妇与新生儿的生存率。但是剖宫产率无节制的逐渐上升使得剖宫产术后子宫瘢痕妊娠(CSP)逐年增多。如果对CSP不进行及时诊治,将严重危及孕妇与新生儿的生命安全。本文首先概述了CSP的发生情况,然后综述了CSP的临床诊治新进展:药物治疗与栓塞治疗、引产方法、手术治疗等,希望为改善CSP预后提供参考。CSP一经确认应立即处理,药物、引产与栓塞治疗能保留生育功能,手术治疗为瘢痕妊娠的治疗提供了最后的保障,降低了患者的死亡率。

At present,with the improvement of medical technology,especially the cesarean section technology,delivery technology and anesthesia technology,the safety and effectiveness of cesarean section have been significantly improved,and the survival rate of pregnant women and newborns has been effectively improved. However,the cesarean section rate increased gradually,resulting in cesarean scar pregnancy（CSP） increased year by year. If CSP after cesarean section is not timely diagnosis and treatment,it will seriously endanger the safety of pregnant women and newborns. This paper summarizes the occurrence of CSP after cesarean section,and then summarizes the new progress in clinical diagnosis and treatment of CSP drug therapy and embolization therapy,induction of labor,surgical treatment and so on,in order to provide a reference for improving the prognosis of CSP. CSP after cesarean section should be treated immediately after confirmation,medication,induction of labor and embolization can preserve fertility,surgical treatment provides the final guarantee for the treatment of scar pregnancy and reduces mortality.