米非司酮治疗低危剖宫产瘢痕妊娠的超声造影评估。
Contrast-Enhanced Ultrasound Evaluation of Mifepristone for Treatment of Low-Risk Cesarean Scar Pregnancy.
机构信息
Department of Obstetrics and Gynecology, Second Clinical Medical College of Army Medical University, Chongqing 400037, China.
Department of Clinical Laboratory, Second Clinical Medical College of Army Medical University, Chongqing 400037, China.
出版信息
Contrast Media Mol Imaging. 2020 Oct 31;2020:3725353. doi: 10.1155/2020/3725353. eCollection 2020.
PURPOSE
The effect of mifepristone for treatment of low-risk cesarean scar pregnancy (CSP) was monitored by contrast-enhanced ultrasound (CEUS).
METHODS
Data were collected from 23 CSP patients with a 10-point risk score <5 (low-risk CSP) and from 23 intrauterine pregnancy (IUP) patients with a scar from a previous cesarean delivery. All patients were prescribed 75 mg mifepristone daily for 2 days and underwent transvaginal CEUS before and after administration of mifepristone. On the third day, uterine curettage was performed after transvaginal CEUS. Arrival time (AT), peak intensity (PI), and area under the curve (AUC) around the gestational sac were monitored by CEUS before and after application of mifepristone, and the rate of effective treatment was compared between the two patient groups.
RESULTS
No patients experienced side effects from either the CEUS procedure or the mifepristone treatment. Changes in AT, PI, and AUC index from before vs. after mifepristone treatment did not differ significantly between the two groups (all values >0.05). There was also no significant difference in the rate of effective treatment between the two groups (95.65% in the CSP group vs. 100% in the IUP group; > 0.05).
CONCLUSIONS
Based on monitoring by CEUS, the effect of mifepristone in low-risk CSP was comparable to that in IUP.
目的
通过对比增强超声（CEUS）监测米非司酮治疗低危剖宫产瘢痕妊娠（CSP）的效果。
方法
收集了 23 例 10 分风险评分<5（低危 CSP）的 CSP 患者和 23 例有剖宫产瘢痕的宫内妊娠（IUP）患者的数据。所有患者均予米非司酮 75mg/d，连用 2 天，并在使用米非司酮前后进行经阴道 CEUS。第 3 天，在经阴道 CEUS 后行子宫刮宫术。在使用米非司酮前后，通过 CEUS 监测孕囊周围的到达时间（AT）、峰值强度（PI）和曲线下面积（AUC），并比较两组患者的有效治疗率。
结果
两组患者均未出现 CEUS 检查或米非司酮治疗的不良反应。两组患者治疗前后 AT、PI 和 AUC 指数的变化差异均无统计学意义（均>0.05）。两组患者的有效治疗率也无统计学差异（CSP 组 95.65% vs. IUP 组 100%；>0.05）。
结论
基于 CEUS 监测，米非司酮治疗低危 CSP 的效果与 IUP 相似。
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