Mo Roxana, Kalburgi Sujatha, Thakur Yatin, Jadhav Jitendra
Department of Obstetrics and Gynaecology, Basildon University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, UK
Department of Obstetrics and Gynaecology, Basildon University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, UK.
BMJ Case Rep. 2021 Apr 15;14(4):e241183. doi: 10.1136/bcr-2020-241183.
Caesarean scar ectopic pregnancies are the rarest type of ectopic pregnancy. The optimum management regime is not yet established. We report the case of a 39-year-old woman who presented at 11 weeks gestation with painless vaginal bleeding, having had 2 previous caesarean sections. Ultrasound revealed a gestational sac within the caesarean scar niche. On follow-up, her serial ß human chorionic gonadotropin (ßHCG) measurements fell significantly. The woman initially opted for conservative management but subsequently required surgical management. Hysteroscopy demonstrated a sac within the caesarean scar which was successfully evacuated by ultrasound-guided suction curettage, with no complications. Caesarean scar ectopic pregnancies are becoming increasingly common. Diagnosis is primarily through ultrasound using specified criteria. Management may be conservative, medical or surgical excision depending on the clinical circumstances. Hysteroscopy and suction curettage is an effective therapeutic option for caesarean scar ectopic management.
剖宫产瘢痕部位异位妊娠是最罕见的异位妊娠类型。目前尚未确立最佳的治疗方案。我们报告一例39岁女性病例，该患者孕11周时出现无痛性阴道出血，既往有2次剖宫产史。超声检查发现剖宫产瘢痕部位有妊娠囊。随访期间，她的血清β-人绒毛膜促性腺激素（β-HCG）测量值显著下降。该女性最初选择保守治疗，但随后需要手术治疗。宫腔镜检查显示剖宫产瘢痕部位有一个囊，通过超声引导下吸刮术成功将其清除，无并发症发生。剖宫产瘢痕部位异位妊娠正变得越来越常见。诊断主要通过超声检查并依据特定标准进行。治疗可根据临床情况选择保守治疗、药物治疗或手术切除。宫腔镜检查及吸刮术是治疗剖宫产瘢痕部位异位妊娠的一种有效治疗选择。
