Litwicka Katarzyna, Greco Ermanno
Assisted Reproduction Centre, European Hospital, Rome, Italy.
Curr Opin Obstet Gynecol. 2013 Dec;25(6):456-61. doi: 10.1097/GCO.0000000000000023.
The current review aims to provide an overview of the already available and emerging treatment modalities for caesarean scar pregnancy (CSP).
CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility.
No universal treatment guidelines for management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendation establishment.
本综述旨在概述剖宫产瘢痕妊娠(CSP)已有的和新出现的治疗方式。
CSP是一种异位妊娠,伴有严重并发症的高风险。这种情况的病因及最佳治疗方法仍不明确。然而,已提出了一些医学和手术治疗方式。CSP临床管理的主要目标应是预防大量失血,并保留子宫以维持进一步的生育能力、女性健康和生活质量。目前的数据表明不应推荐期待治疗,而越来越多的数据表明早期诊断提供了单一或联合的医学和手术治疗选择,可避免子宫破裂和出血,从而保留子宫和生育能力。
目前尚未发布关于CSP管理的通用治疗指南。缺乏最佳证据的数据应鼓励任何个案报告及进一步的多中心研究以建立推荐意见。