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孕中期剖宫产瘢痕妊娠:一例报告

Mid-trimester cesarean scar pregnancy: a case report.

作者信息

Fowler Mary Louise, Little Sarah, Muto Michael, Mahalingaiah Shruthi

机构信息

Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, 6th Floor, Boston, MA, 02118, USA.

Department of Maternal Fetal Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.

出版信息

Fertil Res Pract. 2021 Apr 23;7(1):10. doi: 10.1186/s40738-021-00103-9.

DOI:10.1186/s40738-021-00103-9
PMID:33892816
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8062615/
Abstract

BACKGROUND

This article reports a unique case of cesarean scar pregnancy, demonstrating importance of early management and diagnosis.

CASE PRESENTATION

A 30-year-old pregnant woman with prior history of two cesarean sections found to have cesarean scar pregnancy at approximately 13 weeks' gestation and underwent a gravid hysterectomy.

CONCLUSIONS

While rare, cesarean scar pregnancies should be considered on the differential diagnosis of any pregnant patient with history of cesarean section who presents in early pregnancy with vaginal bleeding and/or cramping. Given the increased rates of cesarean sections in the times of COVID-19, one may anticipate seeing more cases of cesarean scar pregnancies.

摘要

背景

本文报告了一例罕见的剖宫产瘢痕妊娠病例,强调了早期诊断和治疗的重要性。

病例介绍

一名30岁孕妇,既往有两次剖宫产史,孕13周左右被诊断为剖宫产瘢痕妊娠,随后接受了妊娠子宫切除术。

结论

虽然剖宫产瘢痕妊娠较为罕见,但对于有剖宫产史且孕早期出现阴道出血和/或腹痛的孕妇,应考虑此病。鉴于COVID-19期间剖宫产率上升,预计会出现更多剖宫产瘢痕妊娠病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/8063342/66f76c913b57/40738_2021_103_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/8063342/e68134205197/40738_2021_103_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/8063342/66f76c913b57/40738_2021_103_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/8063342/e68134205197/40738_2021_103_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc3a/8063342/66f76c913b57/40738_2021_103_Fig2_HTML.jpg

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1
Mid-trimester cesarean scar pregnancy: a case report.孕中期剖宫产瘢痕妊娠:一例报告
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本文引用的文献

1
Differential Diagnosis of Cesarean Scar Pregnancies and Other Pregnancies Implanted in the Lower Uterus by Ultrasound Parameters.超声参数对剖宫产子宫瘢痕部位妊娠与其他部位妊娠的鉴别诊断。
Biomed Res Int. 2020 Nov 24;2020:8904507. doi: 10.1155/2020/8904507. eCollection 2020.
2
Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China.中国武汉新冠肺炎孕妇的临床特征
N Engl J Med. 2020 Jun 18;382(25):e100. doi: 10.1056/NEJMc2009226. Epub 2020 Apr 17.
3
The clinical outcome of cesarean scar pregnancies implanted "on the scar" versus "in the niche".
剖宫产瘢痕妊娠“着床于瘢痕”与“着床于憩室”的临床结局
Am J Obstet Gynecol. 2017 May;216(5):510.e1-510.e6. doi: 10.1016/j.ajog.2017.01.019. Epub 2017 Jan 20.
4
Scar Ectopic Pregnancy.瘢痕部位异位妊娠
J Obstet Gynaecol India. 2015 Dec;65(6):372-5. doi: 10.1007/s13224-015-0817-3. Epub 2015 Nov 21.
5
Cesarean scar pregnancies: experience of 60 cases.剖宫产瘢痕妊娠:60例经验
J Ultrasound Med. 2015 Apr;34(4):601-10. doi: 10.7863/ultra.34.4.601.
6
Identifying sonographic markers for placenta accreta in the first trimester.识别早孕期胎盘植入的超声标记物。
J Ultrasound Med. 2012 Nov;31(11):1835-41. doi: 10.7863/jum.2012.31.11.1835.
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Analysis of cases with cesarean scar pregnancy.剖宫产瘢痕妊娠病例分析
J Obstet Gynaecol Res. 2013 Jan;39(1):195-202. doi: 10.1111/j.1447-0756.2012.01892.x. Epub 2012 May 28.
8
Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review.剖宫产率升高带来的意外后果:早期胎盘植入和剖宫产瘢痕妊娠。综述。
Am J Obstet Gynecol. 2012 Jul;207(1):14-29. doi: 10.1016/j.ajog.2012.03.007. Epub 2012 Mar 10.
9
Caesarean scar pregnancy.剖宫产瘢痕妊娠
BJOG. 2007 Mar;114(3):253-63. doi: 10.1111/j.1471-0528.2006.01237.x.
10
Cesarean scar ectopic pregnancies: etiology, diagnosis, and management.剖宫产瘢痕部位异位妊娠:病因、诊断与处理
Obstet Gynecol. 2006 Jun;107(6):1373-81. doi: 10.1097/01.AOG.0000218690.24494.ce.