Shah Prishita, Manandhar Rosina, Thapa Meena, Saha Rachana
Departmentof Obstetrics and Gynecology, Kathmandu Medical Collegeand Teaching Hospital, Sinamangal, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2019 May-Jun;57(217):209-212. doi: 10.31729/jnma.4465.
Cesarean scar pregnancy is a rare variant of ectopic pregnancy where the fertilized ovum gets implanted in the myometrium of the previous cesarean scar. The incidence of Caesarean Scar Pregnancy among ectopic pregnancies is 6.1% and it is seen in approximately 1 in 2000 normal pregnancies. As trophoblastic invasion of the myometrium can result in uterine rupture and catastrophic hemorrhage termination of pregnancy is the treatment of choice if diagnosed in the first trimester. Expectant treatment has a poor prognosis and may lead to uterine rupture which may require hysterectomy and subsequent loss of fertility. We present a case report of a 24-year-old female G2P1L1with ruptured cesarean scar pregnancy who underwent emergency laparotomy and subsequently hysterectomy. In this case report, we aim to discuss ruptured cesarean scar pregnancy as obstetric emergency and methods by which we can make an early diagnosis that it can be managed appropriately so as to prevent maternal morbidity and mortality. Keywords: cesarean; hysterectomy; maternal mortality; pregnancy; scar; uterine rupture.
剖宫产瘢痕妊娠是异位妊娠的一种罕见类型，即受精卵着床于既往剖宫产瘢痕的肌层。剖宫产瘢痕妊娠在异位妊娠中的发生率为6.1%，在每2000例正常妊娠中约有1例发生。由于滋养层对肌层的浸润可导致子宫破裂和灾难性出血，如果在孕早期确诊，终止妊娠是首选治疗方法。期待治疗预后较差，可能导致子宫破裂，这可能需要行子宫切除术并随后丧失生育能力。我们报告一例24岁女性G2P1L1剖宫产瘢痕妊娠破裂病例，该患者接受了急诊剖腹手术并随后行子宫切除术。在本病例报告中，我们旨在讨论作为产科急症的剖宫产瘢痕妊娠破裂以及能够进行早期诊断从而得以适当处理以预防孕产妇发病和死亡的方法。关键词：剖宫产；子宫切除术；孕产妇死亡率；妊娠；瘢痕；子宫破裂
