Objective: To investigate the diagnosis and treatment of early and mid-cesarean scar pregnancy. Method: 38 cases early and mid-cesarean scar pregnant patients who were treated in our hospital from Aug. 2005 to Apr. 2011 were involved in this research, and we summarized characters of diagnosis and treatment for cesarean scar pregnancy. Result: All patients had cesarean section history and menopause, and blood HCG of all patients were significantly higher than normal level. 25 patients showed painless irregular vaginal bleeding, and the rest 13 patients had no clinical symptoms. Gynecological B ultrasonic examination 31 scar pregnant patients, and they underwent curettage after conservative treatment of methotrexate and mifepristone. 5 patients were misdiagnosed as threatened abortion, and scar pregnancy was found when they underwent curettage, so these patients underwent curettage again after conservative treatment. 2 patients had massive hemorrhage when underwent abortion and showed hemorrhagic shock symptoms. After anti-shock treatment they underwent hysterectomy. Conclusion: Gynecological B ultrasonic examination is simple and effective in the diagnosis of scar pregnancy, and patients underwent conservative treatment of methotrexate and mifepristone after diagnosis and then underwent curettage.%目的:探讨瘢痕子宫早中期妊娠的诊断和治疗方法.方法:收集2005年8月至2011年4月于我院就诊治疗的38例早中期瘢痕妊娠患者的临床资料,分析总结对这些患者诊断和治疗的特点.结果:所有的患者均有剖宫产史和停经史,且所有患者的HCG含量均明显升高.25例患者表现为无痛性不规则的阴道出血,余13例患者无任何症状.31例患者行妇科B超检查时发现瘢痕妊娠,保守治疗后行清宫术;5例患者误诊为先兆流产,清宫术中发现瘢痕妊娠,保守治疗后再次行清宫术;2例患者人工流产时大出血且出现出血性休克症状,积极抗休克治疗后全切除子宫.结论:妇科B超检查对诊断瘢痕妊娠简便有效,确诊后经甲氨蝶呤联合米非司酮保守治疗后行清宫术.
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