Objective To investigate the value of Color Doppler ultrasound in Cesarean scar pregnancy. Methods 58 cases of Cesarean scar pregnancy were examined with trans-abdominal scan, trans-vaginal scan, trans-abdominal together with trans-vaginal scan. Meanwhile, three scan methods were compared. Results The ultrasonic characteristics of cesarean scar pregnancy showed the gestational sac locating in the lower part of the anterior uterine wall, the thinner myometrium, and the indefinite boundary between them. In 15 cases with trans-abdominal ultrasound only, 10 cases were diagnosed correctly by ultrasound(67%) and 5cases were misdiagnosed(33MS). In 18 cases with trans-vaginal ultrasound only, 14 cases were diagnosed correctly(78%) and 5 cases were misdiagnosed(22%). In 25 cases with trans-abdominal together with trans-vaginal ultrasound, 22 cases were diagnosed correctly (87%) and 3 cases were misdiagnosed(13%). In all 58 cases, 54 showed rich blood supply with low-impedance artery Doppler spectrum, and 4 showed weak blood signals. Conclusions It is valuable to use Trans-abdominal together with trans-vaginal Color Doppler ultrasonography in the early diagnosis of pregnancy in cesarean section scar. Early diagnosis and timely treatment can avoid complications such as massive hemorrhage.%目的 探讨经腹和经阴道联合超声在诊断剖宫产子宫瘢痕部位妊娠(cesarean scars pregnancy,CSP)中的临床价值.方法 对58例剖官产瘢痕部位妊娠的经腹、经阴道和经腹经阴道联合彩色多普勒超声检查情况进行回顾性分析,并将3种超声检查方法进行对比. 结果 剖官产子宫疤痕妊娠的声像图特征为妊娠物位于官腔下段前壁疤痕处,下段随孕周增大而膨大,该处子宫肌层变薄,妊娠物与肌层间界限不清,回声杂乱,经腹组15例,10例超声确诊为剖宫产子宫瘢痕部位妊娠(67％),误诊5例(33％)；经阴道组18例,14例超声确诊为剖官产子宫瘢痕部位妊娠(78％),误诊4例(22％)；联合组25例,22例超声确诊为剖宫产子宫瘢痕部位妊娠(87％),3例误诊(13％).58例患者中54例血流丰富,录到类滋养层低阻动脉样血流频谱,4例血流不明显.结论 经腹及经阴道联合超声检查较单纯经腹或经阴道超声检查对剖宫产子宫疤痕妊娠诊断符合率高.早期诊断该病并及时治疗能减少和避免发生大出血等并发症,并可对治疗效果进行监测和判断.
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