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甲氨蝶呤全身给药联合后续刮宫术成功保守治疗剖宫产瘢痕妊娠:一例报告

Successful conservative treatment of a cesarean scar pregnancy with systemically administered methotrexate and subsequent dilatation and curettage: a case report.

作者信息

Fadhlaoui Anis, Khrouf Mohamed, Khémiri Khaled, Nouira Kais, Chaker Anis, Zhioua Fethi

机构信息

Department of Obstetrics and Gynecology, Aziza Othmana University Hospital (Medical University of Tunis), Place du Gouvernement, La Kasba, 1008 Tunis, Tunisia.

出版信息

Case Rep Obstet Gynecol. 2012;2012:248564. doi: 10.1155/2012/248564. Epub 2012 Jan 31.

Abstract

Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with severe complications such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy, and definitive infertility. Many therapeutic options are available such as Dilatation & Curetage, excision of trophoblastic tissues using either laparotomy or laparoscopy, systemically administered Methotrexate, and more recently uterine artery embolization. The use of Methotrexate sometimes required laparotomy later because of severe hemorrhage. Through this paper, we demonstrated that viable cesarean scar pregnancy can be managed safely by systemically delivered Methotrexate at the cost of a prolonged followup.

摘要

剖宫产瘢痕妊娠是一种罕见的异位妊娠类型,与严重并发症相关,如子宫破裂、难以控制的出血(可能导致子宫切除)以及永久性不孕。目前有多种治疗选择,如刮宫术、通过开腹手术或腹腔镜手术切除滋养层组织、全身应用甲氨蝶呤,以及最近出现的子宫动脉栓塞术。由于严重出血,使用甲氨蝶呤有时后期需要进行开腹手术。通过本文,我们证明了对于存活的剖宫产瘢痕妊娠,采用全身给药甲氨蝶呤可安全治疗,但代价是需要延长随访时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4364/3335663/ecf79e27ba1a/CRIM.OBGYN2012-248564.001.jpg

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