关键词: 剖宫产术, 瘢痕, 妊娠, 异位, 诊断, 治疗

Abstract: Objective： To investigate the influencing factors of cesarean scar pregnancy （CSP） and the suitable measures of diagnosis and treatment. Methods：From January 2007 to August 2012，51 cases were diagnosed as CSP in our hospital. The patients′ information were analyzed such as the indications of cesarean, postoperative recovery and the CSP time. According to patients′ condition curettage, uterine artery embolism, laparoscopic and/or hysteroscopic treatment, exsecting the focus per vagina, hysterectomy were selected. Results：All the cases were diagnosed by transvaginal ultrasound. The time of occurrence CSP were 5-147 months（average 60.5±9.5）. Gravidity 2-6. Excepting 10（19.61%） cases performed cesarean after uterine contraction，41（80.39%）cases were selectively cesarean without any uterine contraction. 48（94.12%） cases were cured successfully by conservative treatment. Of those 8 cases with ultrasonic monitoring, 19 cases after uterine artery embolism, 8 cases monitored by laparoscope or/and hysteroscope, 11 intramuscular or cervical injection with methotrexate, 2 anterior uterine wall neoplasty per vagina. 3 cases were performed hysterectomy with heavy bleeding, one case died of hemorrhagic shock. Conclusions：CSP are high-risk pregnancy, it′s very important with early diagnose and suitable treatment. Transvaginal ultrasound is the preferred diagnostic method of CSP.

Key words: Cesarean section, Cicatrix, Pregnancy, ectopic, Diagnosis, Therapy