剖宫产瘢痕部位妊娠：澳大利亚一家三级转诊中心的回顾性病例系列。
Cesarean scar ectopic pregnancies: a retrospective case series at an Australian tertiary referral center.
机构信息
Women's and Children's Hospital, Adelaide, South Australia, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
出版信息
Int J Gynaecol Obstet. 2022 Dec;159(3):771-775. doi: 10.1002/ijgo.14183. Epub 2022 Mar 28.
OBJECTIVE
To review the management, success, and complication rates of women who presented with a cesarean scar ectopic pregnancy at an Australian tertiary referral center.
METHODS
A retrospective case series was undertaken. Patients were identified through the hospital's clinical information services coding system and data were collected from medical records.
RESULTS
A total of 38 cases were identified. Patients who were hemodynamically stable were predominantly managed according to local expertise via intramuscular, intra-sac methotrexate or a combination of these two. In some cases, surgical management was preferred.
CONCLUSION
Cesarean scar ectopic pregnancy may be managed both surgically and medically. At institutions where surgical expertise is unavailable, medical management would be valuable with few adverse outcomes identified, provided women have closely monitored follow-up.
目的
回顾在澳大利亚一家三级转诊中心就诊的剖宫产瘢痕部位妊娠患者的管理方法、成功率和并发症发生率。
方法
进行了一项回顾性病例系列研究。通过医院的临床信息服务编码系统识别患者，并从病历中收集数据。
结果
共确定了 38 例病例。血流动力学稳定的患者主要根据当地专业知识通过肌内、囊内甲氨蝶呤或两者联合治疗。在某些情况下，更倾向于手术治疗。
结论
剖宫产瘢痕部位妊娠可以通过手术和药物治疗进行管理。在没有手术专业知识的机构中，如果对妇女进行密切监测随访，药物治疗是有价值的，很少有不良后果。
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