Joshi Sayali D, Momin Shenaz A, Shetty Dev
Department of Radiology, Topiwala National Medical College and B.Y.L Nair Charitable Hospital, Mumbai, India.
Pol J Radiol. 2017 Jun 1;82:296-298. doi: 10.12659/PJR.901118. eCollection 2017.
Scar pregnancy is an extremely rare type of ectopic pregnancy, where there is implantation of the gestational sac onto the anterior wall of the uterus at the site of previous LSCS scar in a multipara female. Due to a poor vascular supply to the lower uterine segment, caesarean scars may heal improperly predisposing it to be a site of improper implantation of the gestational sac.
The characteristic features are empty uterus and cervix, gestational sac in the anterior part of lower uterine segment with a history of painless vaginal bleeding. It carries a high risk of morbidity related to uterine rupture and extensive haemorrhage.
In case of a previous LSCS delivery in a female with a viable gestational sac in the lower uterine segment and elevated B-Hcg levels, the possibility of scar ectopic pregnancy should be considered. KCl or methotrexate can be injected directly into the foetal pole under transvaginal ultrasound guidance in order to stop the cardiac activity in the foetus. The knowledge of the specific ultrasound features of uncommon locations of ectopic pregnancies such as an ectopic scar is crucial for a correct diagnosis and early management in order to prevent complications.
瘢痕妊娠是一种极为罕见的异位妊娠类型，指多产妇的妊娠囊着床于既往低位剖宫产瘢痕处的子宫前壁。由于子宫下段血供较差，剖宫产瘢痕可能愈合不良，使其易于成为妊娠囊异常着床的部位。
其特征性表现为子宫和宫颈空虚，子宫下段前部有妊娠囊，并伴有无痛性阴道流血史。它具有与子宫破裂和大量出血相关的高发病风险。
对于既往有低位剖宫产史、子宫下段有存活妊娠囊且β-HCG水平升高的女性，应考虑瘢痕异位妊娠的可能性。可在经阴道超声引导下将氯化钾或甲氨蝶呤直接注入胎囊，以停止胎儿的心跳。了解异位妊娠罕见部位（如瘢痕异位）的特定超声特征对于正确诊断和早期处理以预防并发症至关重要。
