剖宫产瘢痕部位部分性葡萄胎：一例报告及文献复习
Partial molar pregnancy in the cesarean scar: A case report and literature review.
作者信息
Ling Chen, Zhao Jitong, Qi Xiaorong
机构信息
Department of Gynecology and Obstetrics, Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China.
出版信息
Medicine (Baltimore). 2018 Jun;97(26):e11312. doi: 10.1097/MD.0000000000011312.
RATIONALE
The incidence of molar pregnancy in the cesarean scar is exceedingly low, however, the disease may carry a high risk of uncontrolled hemorrhage or uterine rupture. So far managements of this disease were rarely reported in literature.
PATIENT CONCERNS
We reported a 28-year-old woman presented to our hospital with a complaint of amenorrhea for 48 days and vaginal bleeding for 3 days.
DIAGNOSIS
Transvaginal ultrasonography, serum hCG and pelvic MRI confirmed the cesarean scar pregnancy.
INTERVENTIONS
The patient underwent bilateral uterine arterial embolization and suction evacuation.
OUTCOMES
The postoperative histologic examination of the tissue revealed a partial hydatidiform mole.
LESSONS
Molar pregnancy in the cesarean scar is tough to differentiate from normal cesarean scar pregnancy with serum hCG, sonogram or MRI. This case suggested us that it was necessary to perform a histological examination of postoperative specimen for cesarean scar pregnancy.
理论依据
剖宫产瘢痕部位妊娠的发生率极低，然而，该病可能存在大出血或子宫破裂的高风险。迄今为止，关于这种疾病的治疗在文献中鲜有报道。
患者情况
我们报告了一名28岁女性，因停经48天、阴道流血3天前来我院就诊。
诊断
经阴道超声检查、血清人绒毛膜促性腺激素（hCG）检测及盆腔磁共振成像（MRI）确诊为剖宫产瘢痕妊娠。
干预措施
患者接受了双侧子宫动脉栓塞术及清宫术。
结果
术后组织病理检查显示为部分性葡萄胎。
经验教训
剖宫产瘢痕部位妊娠难以通过血清hCG、超声检查或MRI与正常剖宫产瘢痕妊娠相鉴别。该病例提示我们，对于剖宫产瘢痕妊娠，术后标本进行组织学检查很有必要。
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