超声在剖宫产切口部妊娠分型与诊治中的研究进展

Research Progress of Ultrasound in Classification,Diagnosis and Treatment of Cesarean Scar Pregnancy

随着剖宫产率的提高以及国内二胎政策的开放,有剖宫产史但仍选择再次妊娠的女性数量增多,胎盘位置异常的发生率也在逐步上升。子宫瘢痕处妊娠就是胎盘位置异常到达子宫下段愈合的切口上并侵入肌层的一种特殊妊娠。由于剖宫产切口部妊娠(CSP)的临床特点无特异性,一旦CSP患者未能在妊娠早期诊断和接受合理治疗,随着孕周的进展,则可能发生严重的产科并发症,如子宫破裂、严重大出血、休克等,对孕妇的生命健康造成了严重威胁。因此对有剖宫产史的孕妇需要及时运用一些辅助检查尽可能规避风险,超声检查作为妇科常用的检查手段,在CSP的诊断和治疗中表现出巨大的应用潜力。本文就超声在瘢痕妊娠诊断中的研究进展进行综述。

With an increased cesarean delivery rate and the advent of the“one couple two children”policy,the increase in the number of women who choose to become pregnant again despite having a previous cesarean section,and the incidence of abnormal placentation is steadily rising.Cesarean scar pregnancy is a special pregnancy in which the placenta position is abnormal and reaches the incision of the lower segment of uterus and invades the muscular layer.Because of the nonspecific clinical features,once CSP patients fail to receive reasonable diagnosis and treatment in the first trimester of pregnancy,serious obstetric complications may occur with the progress of gestational weeks,such as uterine rupture,severe hemorrhage,shock and so on,which pose a serious threat to the life and health of pregnant women.Therefore,pregnant women with a history of cesarean section need to use some auxiliary examinations in time to avoid risks as much as possible.Ultrasonography,as a common examination method in gynecology,shows great application potential in the diagnosis and treatment of CSP.This article reviews the progress of ultrasound in the diagnosis of scar pregnancy.