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首页> 外文期刊>International Journal of Reproduction, Contraception, Obstetrics and Gynecology >Cesarean scar pregnancy: an upcoming challenge
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Cesarean scar pregnancy: an upcoming challenge

机译：剖宫产疤痕妊娠：即将到来的挑战

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Background: Cesarean scar pregnancy (CSP) is a type of ectopic pregnancy implanted in the myometrium at the site of previous cesarean scar. Incidence of cesarean deliveries are increasing globally, leading to rise in incidence of cesarean scar pregnancy. Caesarean scar pregnancies are associated with some life-threatening complications such as scar rupture, haemorrhage, disseminated intravascular coagulation, requiring lifesaving hysterectomy. We present our experience with 11 patients with cesarean scar pregnancy, diagnosed using transvaginal colour doppler ultrasound during 3-year period and treated conservatively to preserve the uterus with successful outcome in all patients. Methods: This was a retrospective study, conducted in the Department of Obstetrics and Gynecology of DMC&H, Ludhiana from January 2015 to December 2017. Out of total deliveries (4278), 3.9% (171/4278) were diagnosed as ectopic pregnancy. 6.43% (11/171) of them were diagnosed as cesarean scar ectopic pregnancy. After counseling, all patients underwent conservative management. Injection methotrexate 50mg was administered intramuscularly and beta- HCG was monitored after 4 days and then weekly till it was 1. Results: 2 patients had an increase in beta HCG levels on day 7 and required second dose of methotraxate. 8 patients required blood transfusion due to excessive bleeding on admission. In 9 patients beta HCG levels reduced to 1 in 7 weeks post first methotraxate dose administration, and in remaining 3 it returned to 1 after 8 weeks . No patient required any surgical intervention. Conclusions: Cesarean scar pregnancy, a type of ectopic pregnancy can be safely managed conservatively if diagnosed early.
机译：背景：剖宫产疤痕妊娠（CSP）是一种异位妊娠，植入在先前剖宫产瘢痕部位的子宫肌层。剖宫产的发生率在全球范围内正在增加，导致剖宫产疤痕妊娠的发生率上升。剖腹产疤痕妊娠与一些危及生命的并发症有关，例如疤痕破裂，出血，弥散性血管内凝血，需要挽救子宫。我们介绍了11例剖宫产疤痕妊娠患者的经验，这些患者在3年内使用经阴道彩色多普勒超声诊断，并保守治疗以保全子宫，所有患者均获得成功。方法：这是一项回顾性研究，于2015年1月至2017年12月在卢迪亚纳DMC＆H的妇产科进行。在总分娩数（4278）中，有3.9％（171/4278）被诊断为异位妊娠。其中6.43％（11/171）被诊断为剖宫产疤痕异位妊娠。咨询后，所有患者均接受了保守治疗。肌肉注射50mg氨甲蝶呤注射液，4天后监测β-HCG，然后每周监测一次，直到<1。结果：2例患者在第7天的βHCG水平升高，需要再次服用甲氨蝶呤。 8名患者因入院时大量出血而需要输血。在首次服用甲氨蝶呤剂量后的7周内，有9位患者的βHCG水平降至<1，其余3位在8周后恢复至<1。没有患者需要任何手术干预。结论：剖腹产疤痕妊娠是一种异位妊娠，如果及早诊断，可以安全地进行保守治疗。

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