Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostol. Subjects and Methods A t...Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostol. Subjects and Methods A total of 213 pregnant women with amenorrhea of 34~69 d after caesarian section who asked for medical abortion were recruited, including 63 cases undergoing their second medical abortion. A total amount of mifeprisstone of 150 mg given in separate doses (25 mg×4 and 50 mg at the first time) was administered orally within 3 d, followed by misoprostol of 0.6 mg orally in the morning of d 3. Results The complete abortion rate was 92.5%, incomplete abortion was 4.7% and failure was 2.8%. Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section history. Its efficacy was similar to that for ordinary population. Its safety and effectiveness were satisfactory.展开更多
Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy(CSP).Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007,includi...Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy(CSP).Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007,including age,interval from the last cesarean delivery to diagnosis,clinical presentation,location of the lesion,process of diagnosis and treatment,outcome,and follow-up,were retrospectively analyzed.Results CSP constituted 1.05% of all ectopic pregnancies,and the ratio of CSP to pregnancy was 1∶1221.The mean age of the group was 31.4 years.Twenty-six women had only one prior cesarean delivery.The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years.The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding.Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor.The other 9 were diagnosed definitely before treatment.The diagnosis was made based on cesarean delivery history,gynecologic examination,ultrasound,and magnetic resonance imaging(MRI).The treatment of CSP included systemic or local methotrexate administration,conservative surgery,and hysterectomy.The conservative treatment was successful in 24 cases.All of the 28 women were cured through individual therapies.Conclusions CSP is rare and usually misdiagnosed as other diseases.Ultrasound is valuable for diagnosing CSP,and MRI can be used as an adjunct to ultrasound scan.Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients.Individual therapy is strongly recommended.展开更多
Cesarean scar ectopic pregnancy is a consequence of a scar from previous cesarean section.It is rare and is associated with catastrophic complications of early pregnancy.It can occur in women with only one prior cesar...Cesarean scar ectopic pregnancy is a consequence of a scar from previous cesarean section.It is rare and is associated with catastrophic complications of early pregnancy.It can occur in women with only one prior cesarean delivery.With increasing rate of cesarean section worldwide,more and more cases are diagnosed and reported.The incidence is likely to rise substantially in the near future.A delay in diagnosis and the treatment can lead to uterine rupture,major haemorrhage,hysterectomy and serious maternal morbidity.Early diagnosis can offer treatment options of avoiding uterine rupture and haemorrhage,thus preserving the uterus and future fertility.Aim of this article is to find the demography,pathophysiology,clinical presentation,most appropriate methods of early diagnosis and management.展开更多
Myometrial pregnancy developing in a previous caesarean section scar is the rarest of all ectopic pregnancies (EP) and probably one of the most dangerous of all because of the risk of rupture and hemorrhage. The recen...Myometrial pregnancy developing in a previous caesarean section scar is the rarest of all ectopic pregnancies (EP) and probably one of the most dangerous of all because of the risk of rupture and hemorrhage. The recent recognition of this problem means that diagnosis and management are still in their infancy, and there is no consensus regarding the best management of CSP. Methotrexate (MTX) can be administered systemically or locally, or in both ways, with the aid of ultrasound. Patients diagnosed with caesarean scar pregnancies (CSP) in our clinic underwent transvaginal treatment of ectopic pregnancy. Safe and short treatment under transvaginal ultrasonographic (USG) guidance was performed uneventfully in all cases. The operating time ranged from 5 to 10 minutes with no blood loss. Serum β-hCG (β-subunit of human chorionic gonadotrophin) levels declined to normal levels within a month, and patients were discharged without further complications in two or three hours after the procedure. Our cases show that this treatment is effective, safe, and minimally invasive for patients diagnosed with CSP.展开更多
文摘Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostol. Subjects and Methods A total of 213 pregnant women with amenorrhea of 34~69 d after caesarian section who asked for medical abortion were recruited, including 63 cases undergoing their second medical abortion. A total amount of mifeprisstone of 150 mg given in separate doses (25 mg×4 and 50 mg at the first time) was administered orally within 3 d, followed by misoprostol of 0.6 mg orally in the morning of d 3. Results The complete abortion rate was 92.5%, incomplete abortion was 4.7% and failure was 2.8%. Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section history. Its efficacy was similar to that for ordinary population. Its safety and effectiveness were satisfactory.
文摘Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy(CSP).Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007,including age,interval from the last cesarean delivery to diagnosis,clinical presentation,location of the lesion,process of diagnosis and treatment,outcome,and follow-up,were retrospectively analyzed.Results CSP constituted 1.05% of all ectopic pregnancies,and the ratio of CSP to pregnancy was 1∶1221.The mean age of the group was 31.4 years.Twenty-six women had only one prior cesarean delivery.The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years.The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding.Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor.The other 9 were diagnosed definitely before treatment.The diagnosis was made based on cesarean delivery history,gynecologic examination,ultrasound,and magnetic resonance imaging(MRI).The treatment of CSP included systemic or local methotrexate administration,conservative surgery,and hysterectomy.The conservative treatment was successful in 24 cases.All of the 28 women were cured through individual therapies.Conclusions CSP is rare and usually misdiagnosed as other diseases.Ultrasound is valuable for diagnosing CSP,and MRI can be used as an adjunct to ultrasound scan.Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients.Individual therapy is strongly recommended.
文摘Cesarean scar ectopic pregnancy is a consequence of a scar from previous cesarean section.It is rare and is associated with catastrophic complications of early pregnancy.It can occur in women with only one prior cesarean delivery.With increasing rate of cesarean section worldwide,more and more cases are diagnosed and reported.The incidence is likely to rise substantially in the near future.A delay in diagnosis and the treatment can lead to uterine rupture,major haemorrhage,hysterectomy and serious maternal morbidity.Early diagnosis can offer treatment options of avoiding uterine rupture and haemorrhage,thus preserving the uterus and future fertility.Aim of this article is to find the demography,pathophysiology,clinical presentation,most appropriate methods of early diagnosis and management.
文摘Myometrial pregnancy developing in a previous caesarean section scar is the rarest of all ectopic pregnancies (EP) and probably one of the most dangerous of all because of the risk of rupture and hemorrhage. The recent recognition of this problem means that diagnosis and management are still in their infancy, and there is no consensus regarding the best management of CSP. Methotrexate (MTX) can be administered systemically or locally, or in both ways, with the aid of ultrasound. Patients diagnosed with caesarean scar pregnancies (CSP) in our clinic underwent transvaginal treatment of ectopic pregnancy. Safe and short treatment under transvaginal ultrasonographic (USG) guidance was performed uneventfully in all cases. The operating time ranged from 5 to 10 minutes with no blood loss. Serum β-hCG (β-subunit of human chorionic gonadotrophin) levels declined to normal levels within a month, and patients were discharged without further complications in two or three hours after the procedure. Our cases show that this treatment is effective, safe, and minimally invasive for patients diagnosed with CSP.
