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剖宫产瘢痕妊娠:病例报告及文献复习。

Caesarean Scar Pregnancy: A Case Report and a Literature Review.

机构信息

Department of Obstetrics & Gynaecology, University Hospital of Larisa, Mezourlo, 41334 Larisa, Greece.

Hellenic National Public Health Organization-ECDC, Marousi, 15123 Athens, Greece.

出版信息

Medicina (Kaunas). 2022 May 30;58(6):740. doi: 10.3390/medicina58060740.

Abstract

: Caesarean scar pregnancy (CSP) refers to placental implantation on or in the scar of a previous caesarean section and represents a potentially life-threatening condition. CSP is considered a diagnostic challenge in obstetrics, with the diagnosis relying mainly on transvaginal ultrasound (TVS) and the management depending upon case presentation and available healthcare infrastructures. : We present a case of 34-year-old G3P2 with a history of two-previous caesarean sections referred to the outpatient gynaecology clinic of our Department at the 7th week (7/40) of gestation with abnormal early pregnancy TVS findings, illustrating the gestational sac attached to the caesarean scar and a foetal pole with evidence of foetal cardiac activity. We discuss the outcome of an alternative combined medical and surgical approach we followed as well as an updated review of the current literature. : The ideal management of CSP requires tertiary centers, equipment availability and experienced healthcare professionals capable of dealing with any possible complication, as well as individualized treatment based on each case presentation.

摘要

剖宫产瘢痕妊娠(CSP)是指胎盘着床于或植入到先前剖宫产子宫切口瘢痕处,是一种潜在的危及生命的疾病。CSP 是妇产科领域的一个诊断难题,主要依靠经阴道超声(TVS)进行诊断,具体治疗方案则取决于具体病情和现有的医疗资源。

我们报告了一例 34 岁经产妇,G3P2,有两次剖宫产史,在妊娠 7 周(7/40)时因异常早孕 TVS 结果转诊至我科门诊,TVS 显示孕囊附着于剖宫产瘢痕处,且见胎心血管搏动的胎芽。我们讨论了我们采用的一种替代的联合药物和手术治疗方法的结果,并对当前文献进行了更新回顾。

CSP 的理想治疗需要三级医疗中心、设备和经验丰富的医疗专业人员,以便能够处理任何可能的并发症,同时需要根据每个病例的具体情况进行个体化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6fb/9227540/6a82dab9db99/medicina-58-00740-g001.jpg

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