Management of Cesarean Scar Pregnancy: A Case Series

作     者：Min-hui Guo Mei-fen Wang Man-man Liu Feng Qi Fan Qu Jian-hong Zhou 

作者机构：Department of Gynecology and Obstetrics Women’s Hospital School of Medicine Zhejiang University Department of Gynecology and Obstetrics Taizhou Hospital of Zhejiang Province 

出 版 物：《Chinese Medical Sciences Journal》 (中国医学科学杂志（英文版）)

年 卷 期：2015年第30卷第4期

页      面：226-230页

核心收录：

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：cesarean scar pregnancy transvaginal ultrasound curettage uterine artery embolization laparotomy 

摘      要：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, P0.05). Conclusions The accurate diagnosis of CSP is important. Curettage after UAE with or without local MTX infusion is a safe and effective method.