BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP a...BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP are now diagnosed early and can be managed safely.However,some atypical patients are misdiagnosed,and their surgical risks are underestimated,increasing the risk of fatal hemorrhage.CASE SUMMARY A 27-year-old Asian woman visited our institution because of abnormal pregnancy,and she was diagnosed with a hydatidiform mole through transvaginal ultrasound(TVS).Under hysteroscopy,a large amount of placental tissue was found in the scar of the lower uterine segment,and a sudden massive hemorrhage occurred during the removal process.The bilateral internal iliac arteries were temporarily blocked under laparoscopy,and scar resection and repair were rapidly performed.She was discharged in good condition 5 d after the operation.CONCLUSION Although TVS is widely used in the diagnosis of CSP,delays in the diagnosis of atypical CSP remain.Surgical treatment following internal iliac artery temporary occlusion may be an appropriate management method for unanticipated massive hemorrhage during CSP surgery.展开更多
Objective:To explore the clinical diagnostic value of color Doppler ultrasound in caesarean section scar healing.Methods: The study time: From December 2016 to November 2017 in our hospital 106 cases of cesarean secti...Objective:To explore the clinical diagnostic value of color Doppler ultrasound in caesarean section scar healing.Methods: The study time: From December 2016 to November 2017 in our hospital 106 cases of cesarean section after cesarean uterine scar diagnosis, Among them, 53 cases were in the test group, and 53 cases were better than those in the control group, All cesarean parturients were examined by color Doppler ultrasound through the transvaginal and transabdominal. The image features and accuracy of the diagnosis were observed.Results: after examination, the distance between the scar site and the internal cervical of the test group was closer than that of the control group, and the proportion of the posterior uterus in the test group was much higher than that in the control group. At the same time, there was no significant difference in the size of uterus, endometrial thickness, and follicular diameter between the two groups of parturients after the color ultrasound examination.Conclusion: for the poor healing uterus incision scar parts after cesarean section. The combination of vaginal and abdominal color Doppler ultrasonography has high accuracy and has a certain guiding role in clinical treatment. It can be widely applied in clinic.展开更多
Objective To survey effective treatment strategies for cesarean scar pregnancy(CSP). Methods The clinical data of 78 patients diagnosed with CSP from January 2010 to December 2013 were reviewed. Results Among these pa...Objective To survey effective treatment strategies for cesarean scar pregnancy(CSP). Methods The clinical data of 78 patients diagnosed with CSP from January 2010 to December 2013 were reviewed. Results Among these patients, 17 patients were first treated at our hospital; of them, 2 were misdiagnosed. The other 61 patients were referred from other hospitals; of them, 21 were initially misdiagnosed. There were 9 patients who were treated with laparotomy, 50 patients with curettage after uterine artery embolization(UAE) with or without local methotrexate(MTX) infusion, 10 patients with dilatation and curettage, 6 patients with transvaginal sonographic guided local intragestational MTX injection, and 3 patients with systemic MTX injection. All patients finally recovered. Patients with excessive vaginal hemorrhage underwent either emergency UAE treatment or laparotomy. These two treatments had similar success rates(81.82% vs. 100%, χ2 =0.289, P>0.05). Conclusions The accurate diagnosis of CSP is important. Curettage after UAE with or without local MTX infusion is a safe and effective method.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
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
Uterine incarceration is a rare disease of abnormal uterine morphology, the proportion during pregnancy was 1 in 3000 - 10,000. Previously reported patients with uterine incarceration have different symptoms. Rarely, ...Uterine incarceration is a rare disease of abnormal uterine morphology, the proportion during pregnancy was 1 in 3000 - 10,000. Previously reported patients with uterine incarceration have different symptoms. Rarely, asymptomatic cases persist into the third trimester of pregnancy. In fact, the patients with uterine incarceration can be asymptomatic and normally carry their fetuses to the term because it mainly changes the cervix, which does not affect fetal growth in utero directly. Additionally, cesarean section is both a treatment and a direct method to clarify the diagnosis again, and low-molecular-heparin anticoagulant therapy should be considered immediately after surgery. Here, we present two cases clarifying that patients with uterine incarceration can be pregnant without any discomfort during pregnancy and provide a successful treatment plan.展开更多
Despite the optimal therapeutic protocols of cesarean scar pregnancy （CSP） has not been established, and in the majority of cases, most of women＇s uterus and fertility can be preserved through prompt and active tre...Despite the optimal therapeutic protocols of cesarean scar pregnancy （CSP） has not been established, and in the majority of cases, most of women＇s uterus and fertility can be preserved through prompt and active treatment. But due to the rarity of CSP, little is known about the outcome of subsequent pregnancies, especially in an even rarer situation, a recurrent CSP. We report 2 cases of recurrent CSP women who want to preserve their fertility treated by repeated uterine artery embolization and provide a review of the literatures.展开更多
基金Supported by Medical Health Science and Technology Project of Zhejiang Province,China,No.2020ZH003。
文摘BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP are now diagnosed early and can be managed safely.However,some atypical patients are misdiagnosed,and their surgical risks are underestimated,increasing the risk of fatal hemorrhage.CASE SUMMARY A 27-year-old Asian woman visited our institution because of abnormal pregnancy,and she was diagnosed with a hydatidiform mole through transvaginal ultrasound(TVS).Under hysteroscopy,a large amount of placental tissue was found in the scar of the lower uterine segment,and a sudden massive hemorrhage occurred during the removal process.The bilateral internal iliac arteries were temporarily blocked under laparoscopy,and scar resection and repair were rapidly performed.She was discharged in good condition 5 d after the operation.CONCLUSION Although TVS is widely used in the diagnosis of CSP,delays in the diagnosis of atypical CSP remain.Surgical treatment following internal iliac artery temporary occlusion may be an appropriate management method for unanticipated massive hemorrhage during CSP surgery.
文摘Objective:To explore the clinical diagnostic value of color Doppler ultrasound in caesarean section scar healing.Methods: The study time: From December 2016 to November 2017 in our hospital 106 cases of cesarean section after cesarean uterine scar diagnosis, Among them, 53 cases were in the test group, and 53 cases were better than those in the control group, All cesarean parturients were examined by color Doppler ultrasound through the transvaginal and transabdominal. The image features and accuracy of the diagnosis were observed.Results: after examination, the distance between the scar site and the internal cervical of the test group was closer than that of the control group, and the proportion of the posterior uterus in the test group was much higher than that in the control group. At the same time, there was no significant difference in the size of uterus, endometrial thickness, and follicular diameter between the two groups of parturients after the color ultrasound examination.Conclusion: for the poor healing uterus incision scar parts after cesarean section. The combination of vaginal and abdominal color Doppler ultrasonography has high accuracy and has a certain guiding role in clinical treatment. It can be widely applied in clinic.
文摘Objective To survey effective treatment strategies for cesarean scar pregnancy(CSP). Methods The clinical data of 78 patients diagnosed with CSP from January 2010 to December 2013 were reviewed. Results Among these patients, 17 patients were first treated at our hospital; of them, 2 were misdiagnosed. The other 61 patients were referred from other hospitals; of them, 21 were initially misdiagnosed. There were 9 patients who were treated with laparotomy, 50 patients with curettage after uterine artery embolization(UAE) with or without local methotrexate(MTX) infusion, 10 patients with dilatation and curettage, 6 patients with transvaginal sonographic guided local intragestational MTX injection, and 3 patients with systemic MTX injection. All patients finally recovered. Patients with excessive vaginal hemorrhage underwent either emergency UAE treatment or laparotomy. These two treatments had similar success rates(81.82% vs. 100%, χ2 =0.289, P>0.05). Conclusions The accurate diagnosis of CSP is important. Curettage after UAE with or without local MTX infusion is a safe and effective method.
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.
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Uterine incarceration is a rare disease of abnormal uterine morphology, the proportion during pregnancy was 1 in 3000 - 10,000. Previously reported patients with uterine incarceration have different symptoms. Rarely, asymptomatic cases persist into the third trimester of pregnancy. In fact, the patients with uterine incarceration can be asymptomatic and normally carry their fetuses to the term because it mainly changes the cervix, which does not affect fetal growth in utero directly. Additionally, cesarean section is both a treatment and a direct method to clarify the diagnosis again, and low-molecular-heparin anticoagulant therapy should be considered immediately after surgery. Here, we present two cases clarifying that patients with uterine incarceration can be pregnant without any discomfort during pregnancy and provide a successful treatment plan.
基金supported by Medical Science and Technology Research Fund of Guangdong(No.B2013063)
文摘Despite the optimal therapeutic protocols of cesarean scar pregnancy （CSP） has not been established, and in the majority of cases, most of women＇s uterus and fertility can be preserved through prompt and active treatment. But due to the rarity of CSP, little is known about the outcome of subsequent pregnancies, especially in an even rarer situation, a recurrent CSP. We report 2 cases of recurrent CSP women who want to preserve their fertility treated by repeated uterine artery embolization and provide a review of the literatures.
