Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, 70300 Zerifin, Israel.
J Ultrasound Med. 2011 Sep;30(9):1179-84. doi: 10.7863/jum.2011.30.9.1179.
The purpose of this study was to assess fertility performance and obstetric outcomes after treatment of cesarean scar pregnancy.
We conducted a retrospective study in a large tertiary hospital in Israel. The study included 18 women with a diagnosis of cesarean scar pregnancy between 2000 and 2009.
The incidence of cesarean scar pregnancy among our parturient patients was 1 per 3000 for the general obstetric population and 1 per 531 among those with at least 1 cesarean delivery. Sixteen were treated primarily with methotrexate. Two were treated primarily by surgery, and 2 more were treated by surgery after failed methotrexate treatment. After cesarean scar pregnancy treatment, 7 women conceived spontaneously, and 1 conceived by in vitro fertilization-intracytoplasmic sperm injection. The remaining 10 (55%) did not wish to conceive again. Two of the women who became pregnant (25%) had recurrent cesarean scar pregnancy.
This study shows encouraging results for fertility performance and obstetric outcomes after treatment of cesarean scar pregnancy. Nevertheless, the risk of recurrent cesarean scar pregnancy is not negligible.
本研究旨在评估剖宫产瘢痕妊娠治疗后的生育能力和产科结局。
我们在以色列的一家大型三级医院进行了一项回顾性研究。该研究纳入了 18 名 2000 年至 2009 年间诊断为剖宫产瘢痕妊娠的患者。
我们的分娩患者中，剖宫产瘢痕妊娠的发生率为每 3000 例一般产科人群中有 1 例，每 531 例有至少 1 次剖宫产的患者中有 1 例。16 例患者主要接受甲氨蝶呤治疗。2 例患者主要接受手术治疗，另有 2 例患者在甲氨蝶呤治疗失败后接受手术治疗。剖宫产瘢痕妊娠治疗后，7 例患者自然受孕，1 例患者通过体外受精-胞浆内单精子注射受孕。其余 10 例（55%）患者不想再次怀孕。2 名怀孕的患者（25%）发生了复发性剖宫产瘢痕妊娠。
本研究显示剖宫产瘢痕妊娠治疗后的生育能力和产科结局令人鼓舞。然而，复发性剖宫产瘢痕妊娠的风险不容忽视。
