剖宫产术后子宫瘢痕妊娠的诊治进展

Progress in diagnosis and treatment of uterine scar pregnancy after cesarean section

随着二孩政策开放,手术分娩率呈逐年上升趋势。子宫疤痕妊娠又称为异位妊娠,有过剖宫产史女性为高发人群,孕囊着床于剖宫产切口瘢痕上,存在着巨大风险,若得不到及时诊治患者可出现子宫破裂、休克、大出血等严重并发症。当前还没有关于剖宫产术后子宫瘢痕妊娠诊治的指南,临床干预主要措施为早期诊治、预防并发症、保留生殖能力等。主要的治疗方法为手术、药物,治疗方案需要根据患者病情、生育意愿等制订。早期诊断与治疗是规避大出血、前置胎盘、子宫破裂等不良并发症出现的关键。本文主要就剖宫产术后子宫瘢痕妊娠的诊治展开综述。

With the opening of the two-child policy,the rate of surgical delivery is increasing year by year.Uterine scar pregnancy is also called ectopic pregnancy,women with a history of cesarean section are at high risk.Implantation of gestational sac on the scar of cesarean section incision is at great risk.Without timely diagnosis and treatment,severe complications such as uterine rupture,shock and massive hemorrhage can occur.At present,there are no guidelines for the diagnosis and treatment of uterine scar pregnancy after cesarean section.The main clinical interventions are early diagnosis and treatment,prevention of complications,and preservation of reproductive capacity.The main treatment methods are surgery and medicine.The treatment plan should be formulated according to the patient’s condition and fertility intention.Early diagnosis and treatment is the key to avoid the occurrence of adverse complications such as massive hemorrhage,placenta previa and uterine rupture.This article reviews the diagnosis and treatment of uterine scar pregnancy after cesarean section.