Iyibozkurt A C, Topuz S, Gungor F, Kalelioglu I H, Cigerli E, Akhan S E
Department of Obstetrics and Gynecology, Istanbul Medical School, Istanbul University.
Clin Exp Obstet Gynecol. 2008;35(1):73-5.
Pregnancy implanted in a cesarean scar is rare, and is a life-threatening condition due to high risk of uterine rupture, hemorrhage, hysterectomy, and maternal mortality.
We describe a 26-year-old woman who presented with five weeks of amenorrhea and a serum hCG level of 10,440 mIU/ml. Transvaginal sonography revealed a gestational sac of 15 x 11 mm containing a yolk sac located in a previous cesarean scar. She was successfully treated conservatively with multi-dose methotrexate. No side-effects were encountered. The serum hCG levels were undetectable in 58 days. The patient had normal menstrual cycles afterwards.
In the view of increasing cesarean rates, healthcare professionals should be aware of the possibility of a scar pregnancy and the potentially life threatening sequelae. Early diagnosis by transvaginal sonography can improve outcome and minimize the need for emergent surgery. Conservative treatment with systemic methotrexate is an effective option in selected patients.
剖宫产瘢痕妊娠较为罕见，因子宫破裂、出血、子宫切除及孕产妇死亡风险高，是一种危及生命的情况。
我们描述了一名26岁女性，停经5周，血清人绒毛膜促性腺激素（hCG）水平为10440 mIU/ml。经阴道超声检查发现一个15×11 mm的妊娠囊，内有卵黄囊，位于既往剖宫产瘢痕处。她接受多剂量甲氨蝶呤保守治疗成功。未出现副作用。58天后血清hCG水平检测不到。此后患者月经周期正常。
鉴于剖宫产率不断上升，医疗保健专业人员应意识到瘢痕妊娠的可能性及其潜在的危及生命的后果。经阴道超声早期诊断可改善结局并减少急诊手术的必要性。对于选定患者，全身应用甲氨蝶呤保守治疗是一种有效的选择。
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