剖宫产术后子宫瘢痕憩室妇女再妊娠相关问题探讨

The investigation of relevant problems on the subsequent pregnancy of patients with uterine scar diverticulum after cesarean section

剖宫产瘢痕憩室(CSD)是剖宫产术远期并发症之一,再次妊娠时有可能出现瘢痕憩室妊娠、凶险性前置胎盘伴植入、子宫破裂等危及母胎安全的严重不良结局。当CSD患者面临再次生育,是期待保守观察,还是孕前积极手术,手术治疗的指证及最佳手术方式、孕期监测、妊娠结局等是目前妇产科界需要重视及亟待解决的问题。目前我国“二孩”政策全面放开,有必要对这部分计划再次妊娠的CSD患者的临床诊疗进行规范,并探索出相应的诊疗指南以指导临床实践。

Caesarean scar diverticulum(CSD)is one of the long-term complications after cesarean section,which would cause some adverse results of endangering maternal and child’s lives in the subsequent pregnancy,such as scarred diverticulum pregnancy,dangerous placenta previa with implantation,and uterine rupture.When the patients with CSD needs reproduction,the problems that need to be paid attention to and to be solved urgently in the field of obstetrics and gynecology are included whether to expect conservative observation or active operation before pregnancy,the indication of surgical treatment,and the best type of surgical procedure,monitoring during pregnancy,pregnancy outcomes,and so on.Since"two-child"policy in China is implemented,it is necessary to standardize the clinical diagnosis and treatment of patients with CSD and fertility requirements.And the corresponding diagnostic guidelines should be explored to guide the clinical practice.