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目的探讨剖宫产术后瘢痕妊娠的临床诊断与治疗方法。方法对本院10例剖宫产术后瘢痕妊娠的资料进行回顾性分析。结果 10例均有子宫下段剖宫产史,2例于突然出现无痛性大量阴道出血而来院急诊,诊断为子宫瘢痕处妊娠破裂,予行子宫切除术;1例因停经8周B超提示子宫疤妊娠,行开腹行瘢痕妊娠切除术;4例停经7周,B超提示瘢痕妊娠,收入院后给予药物治疗。2例停经7～12周,其中两例B超提示瘢痕妊娠,头臀长分别为33cm及41cm,见包块向膀胱突出,药物治疗后行子宫瘢痕妊娠组织切除+瘢痕缺陷修补术。另1例停经7+周孕囊小未经预处理直接手术。结论剖宫产术后早期妊娠应注意瘢痕妊娠的发生,提高其诊断率可减少子宫切除率。
Objective To investigate the clinical diagnosis and treatment of scar pregnancy after cesarean section. Methods The data of 10 cases of scar pregnancy after cesarean section in our hospital were retrospectively analyzed. Results All 10 cases had the history of cesarean section in the lower uterine segment, 2 cases of sudden painless mass vaginal bleeding and hospital emergency, diagnosis of pregnancy rupture of the uterine scar, for hysterectomy; 1 case of menopause due to B- Scar pregnancy, line open line scar pregnancy excision; 4 cases of menopause 7 weeks, B-ultrasound prompted scar pregnancy, hospitalized after drug treatment. Two cases of menopause 7 to 12 weeks, of which two cases of B-Tip scar pregnancy, head and rump length were 33cm and 41cm, see the mass of the bladder to the bag, the line after treatment of uterine scar pregnancy tissue repair + scar defect repair. Another case of menopause 7 + Week gestational sac without direct preoperative treatment. Conclusion Early pregnancy after cesarean section should pay attention to the occurrence of scar pregnancy, and improve the diagnosis rate can reduce the hysterectomy rate.