Sokołowska MaŁgorzata, Rajewska Aleksandra, Mikołajek-Bedner Wioletta, Lebdowicz Joanna, Nurek Karolina, Kwiatkowski Sebastian, TorbÉ Andrzej
Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, Poland.
Pol Merkur Lekarski. 2020 Jun 17;48(285):179-183.
The current increase in the percentage of cesarean sections is accompanied by a significant growth in the incidence of cesarean scar pregnancies (CSP) located in the lower uterine segment, while the advancements in diagnostic ultrasound techniques have led to an increased number of CSP diagnoses. A misdiagnosed cesarean scar pregnancy, or one that is diagnosed too late, is a threat to the pregnant patient's life, and predisposes her to such complications as hemorrhage or uterine rupture, which often necessitate hysterectomy and therefore result in irreversible fertility loss. In this paper 4 cases of ectopic pregnancies located within the cesarean scar in women hospitalized at the university clinical center, within a short span of merely three months in 2018, are presented. The purpose of this paper is to indicate to doctors and gynecology and obstetric societies that there is a very urgent need for drawing up guidelines for CSP management. To this effect, information about individual cases should be gathered and analyzed thoroughly, latest reports followed, and knowledge skills and experience shared in order to be able to work out a procedure that is both effective and as safe as possible.
目前剖宫产率的上升伴随着子宫下段剖宫产瘢痕妊娠(CSP)发生率的显著增长,而诊断性超声技术的进步导致CSP诊断数量增加。误诊的剖宫产瘢痕妊娠或诊断过晚的情况,对孕妇生命构成威胁,并使她易发生出血或子宫破裂等并发症,这些并发症往往需要进行子宫切除术,从而导致不可逆的生育能力丧失。本文介绍了2018年仅三个月内,在大学临床中心住院的4例剖宫产瘢痕部位异位妊娠的病例。本文的目的是向医生以及妇产科协会指出,制定CSP管理指南非常迫切。为此,应全面收集和分析个别病例的信息,跟踪最新报告,并分享知识、技能和经验,以便能够制定出一种既有效又尽可能安全的程序。