Department of Obstetrics and Pathology of Pregnancy, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin, 20-081 Lublin, Poland.
Department of Pathomorphology, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin, 20-081 Lublin, Poland.
Int J Environ Res Public Health. 2021 Nov 15;18(22):11998. doi: 10.3390/ijerph182211998.
The definition of a cesarean scar pregnancy (CSP) is the localization of the gestational sac (GS) in the cicatrix tissue, which is created in the front wall of the uterus after a previous cesarean section (CS). The worldwide prevalence of CSP has been growing rapidly. However, there are no general recommendations regarding prophylaxis and treatment of the abnormalities of the anterior wall of the uterus discovered in a non-pregnant myometrium, or how to deal with existing cases of CSP. We present the latest knowledge, a holistic approach to the biology, histology, imaging, and management concerning post-CS scars based on our cases, which were treated in the Department of Pregnancy and Pathology of Pregnancy in the Medical University of Lublin, Poland. In our study, we present images of tissue samples of areas with a cicatrix in the uterus, and ultrasound and MRI images of CSP. We discuss the advances in the biology of the post-CS scar tissue, the prevention techniques used to repair the scar defect (niche) before the pregnancy, and the treatment of different complications of CSP, such as the rupture of the gravid uterus or the dehiscence of the myometrium.
剖宫产瘢痕妊娠（CSP）的定义是妊娠囊（GS）位于前次剖宫产子宫前壁瘢痕处。全世界 CSP 的患病率正在迅速增长。然而，对于在非妊娠子宫肌层中发现的前壁异常的预防和治疗，或者如何处理现有的 CSP 病例，尚无普遍建议。我们根据波兰卢布林医科大学妊娠和妊娠病理学系的病例，介绍了有关 CS 后疤痕的生物学、组织学、影像学和管理的最新知识和整体方法。在我们的研究中，我们展示了子宫瘢痕处组织样本的图像，以及 CSP 的超声和 MRI 图像。我们讨论了 CS 后疤痕组织生物学的进展、用于在怀孕前修复疤痕缺陷（腔隙）的预防技术，以及 CSP 的不同并发症的治疗，如妊娠子宫破裂或子宫肌层破裂。
