国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (1): 67-70.

• 综述 • 上一篇    下一篇

剖宫产术后子宫瘢痕部位妊娠

杨 华, 魏振河   

  1. 300100 天津市中心妇产科医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-01-15 发布日期:2013-01-15

Scar Pregnancy After Cesarean Section

YANG Hua，WEI Zhen-he   

  1. Tianjin Central Hospital of Gynecology Obstetrics，Tianjin 300100，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-01-15 Online:2013-01-15

PDF (PC)

7414

摘要： 剖宫产术后子宫瘢痕部位妊娠（CSP）是罕见的异位妊娠形式之一，但随着全世界剖宫产的增加，诊断及报道越来越多。早期诊断、及时治疗可避免子宫破裂及出血，保留患者的生育能力。阴道超声及彩色多普勒诊断的准确率很高。妊娠早期一旦确诊应立即终止妊娠，由于存在子宫破裂的风险，所以不主张进行期待疗法，甲氨蝶呤有一定的治疗作用。目前，对于是否会重复发生子宫瘢痕部位妊娠、发生子宫瘢痕部位妊娠与前次剖宫产间隔的时间以及剖宫产术缝合技术对发生子宫瘢痕部位妊娠的影响等问题还在探究之中，以期寻找主要致病因素、临床表现、最佳的诊断和合理的治疗方法。

关键词: 剖宫产术, 妊娠, 异位, 超声检查, 妊娠滋养细胞肿瘤, 甲氨蝶呤

Abstract: Cesarean scar pregnancy （CSP） is one of the rare forms of ectopic pregnancy. With the increasing cesarean sections （CS） around the world，more and more CSP cases were diagnosed and reported. Early diagnosis and treatment can retain the fertility，and avoid uterine rupture or bleeding. Transvaginal sonography and color Doppler can be used to confirm CSP diagnosis. Once the diagnoses of CSP was made，pregnancy should be terminated immediately. Because of the high risk of uterine rupture，the expectant treatment should not be recommended. Methotrexate has therapeutic effect. At present，it is necessary to study further the CSP recurring，the time between CSP and the previous CS，and the effect of suture technique of CS on CSP，which is helpful to find the main causes，clinical manifestations，the best diagnosis and reasonable treatment of CSP.

Key words: Cesarean section, Pregnancy, ectopic, Ultrasonography, Gestational trophoblastic neoplasms, Methotrexate