超声技术在子宫瘢痕妊娠诊治中的应用进展
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摘要
<正>剖宫产术后子宫瘢痕妊娠(cesarean scar pregnancy,CSP)是孕囊着床于前次剖宫产子宫切口瘢痕处的特殊部位异位妊娠,其定义仅限于早孕期(≤12周),是剖宫产术后远期严重并发症之一~([1])。近年来,随着剖宫产率的不断升高,CSP的发生率也呈现出逐年增长的趋势,预防CSP发生、早期诊断、合理治疗及防止大出血、子宫破裂等严重并发症的发生、保留患者生育功能尤为重
引文
[1] 金力,陈蔚琳,周应芳.剖宫产术后子宫瘢痕妊娠诊治专家共识(2016) [J].全科医学临床与教育,2017,15(1):5-9.
[2] Parker V L,Srinivas M .Non-tubal ectopic pregnancy [J].Archives of Gynecology and Obstetrics,2016,294(1):19-27.
[3] MAYMON R,SVIRSKY R,SMORGICK N,et al.Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy [J].Journal of Ultrasound in Medicine :Official Journal of the American Institute of Ultrasound in Medicine,2011,30(9):1179-1184.
[4] Seow KM,Huang LW,Lin YH,et al.A Cesarean scar pregnancy:issues in management [J].Ultrasound Obstet Gynecol,2004,23(3):247-253.
[5] PISKUNOVA E V.Clinical significance of office hysteroscopy in examination algorithm of partly faulty uterus scar after cesarean section on the stage of pregnancy planning [J].Journal of Minimally Invasive Gynecology,2016,22(6S):S190.
[6] LITWICKA K,GRECO E.Caesarean scar pregnancy:a review of management options [J].Current Opinion in Obstetrics & Gynecology,2011,23(6):415-421.
[7] Sel G,Sucu S,Harma M,et al.Successful management of cesarean scar pregnancy with vacuum extraction under ultrasound guidance[J].Acute Med Surg,2018,5(4):358-361.
[8] Yu HR,Kang J,Wei N,et al.Application of color Doppler ultrasound in the diagnosis and treatment of cesarean scar pregnancy after cesarean section [J].Shan Dong Yi Yao,2015 55:47.
[9] 马鹰,祝海城,何大馨.超声联合3.0 MRI在剖宫产术后切口瘢痕妊娠中诊断价值分析 [J].中国CT和MRI杂志,2017,15(4):111-113,132.
[10] OUYANG Zhenbo,YIN Qian,XU Yujing,et al.Heterotopic cesarean scar pregnancy:diagnosis,treatment,and prognosis [J].Journal of Ultrasound in Medicine :Official Journal of the American Institute of Ultrasound in Medicine,2014,33(9):1533-1537.
[11] PAS K,JOANNA S M,RENATA R,et al.Prospective study concerning 71 cases of caesarean scar endometriosis (CSE) [J].Journal of Obstetrics and Gynaecology,2017,37(6):775-778.
[12] TAKEDA A,IMOTO S,SAKAI K,et al.Three-dimensional computed tomographic angiography in the diagnosis and conservative management of cesarean scar pregnancy with prominent neovascularization [J].Taiwanese Journal of Obstetrics & Gynecology,2014,53(3):385-388.
[13] Collins K,Kothari A .Catastrophic consequences of a caesarean scar pregnancy missed on ultrasound [J].Australasian Journal of Ultrasound in Medicine,2015,18(4):150-156.
[14] WU Q-y,LING J,XUE Q,et al.Clinical analysis of diagnosis and treatment of 13 cases with cesarean scar pregnancy [J].Clinical and Experimental Obstetrics & Gynecology,2014,41(2):128-131.
[15] LIU Jie,CHAI Yi-qing,YU Yang,et al.The value of 3-dimensional color Doppler in predicting intraoperative hemorrhage for cesarean scar pregnancy [J].Medicine,2018,97(33):e 11969.
[16] GUI Ting,PENG Ping,LIU Xinyan,et al.Clinical and ultrasound parameters in prediction of excessive hemorrhage during management of cesarean scar pregnancy [J].Therapeutics and Clinical Risk Management,2017,13:807-812.
[17] RIGGS B J,COHEN J S,SHIVAKUMAR B A,et al.Doppler ultrasonography of the central retinal vessels in children with brain death [J].Pediatric Critical Care Medicine,2017,18(3):258-264.
[18] TROISI A,ORLANDI R,BARGELLINI P A,et al.Contrast-enhanced ultrasonographic characteristics of the diseased canine prostate gland [J].Theriogenology,2015,84(8):1423-1430.
[19] XIONG Xi,YAN Ping,GAO Chun-yan,et al.The value of Contrast-Enhanced ultrasound in the diagnosis of cesarean scar pregnancy [J].BioMed Research International,2016,10(8):237-250.
[20] Vial Y,Petignat P,Hohlfeld P.Pregnancy in a cesarean scar [J].Ultrasound Obstet Gynecol,2000(6),16:592-593.
[21] ZHANG Hong-wen,HUANG Jing-rui,WU Xian-qing,et al.Clinical classification and treatment of cesarean scar pregnancy [J].Journal of Obstetrics and Gynaecology Research,2017,43(4):653-661.
[22] LIN S Y,HSIEH C J,TU Yi-an,et al.New ultrasound grading system for cesarean scar pregnancy and its implications for management strategies:An observational cohort study [J].PLOS One,2018,13(8):e 0202020.
[23] 梁珍,周婷,罗满秀.彩色多普勒超声在子宫瘢痕妊娠诊断和治疗中的应用 [J].中国现代医生,2017,55(33):99-101,169.
[24] KUTUK M S,UYSAL G,DOLANBAY M,et al.Successful medical treatment of cesarean scar ectopic pregnancies with systemic multidose methotrexate:single-center experience [J].The Journal of Obstetrics and Gynaecology Research,2014,40(6):1700-1706.
[25] ZHANG Ying,DUAN Hua,CHENG Jiu-mei,et al.Treatment options to terminate persistent cesarean scar pregnancy [J].Gynecologic and Obstetric Investigation,2013,75(2):115-119.
[26] KOCHHAR P K,SARANGAL M,GUPTA U.Conservative management of cesarean scar pregnancy with uterine arteriovenous malformation:a case report [J].The Journal of Reproductive Medicine,2013,58(1/2):81-84.
[27] BIGNARDI T,CONDOUS G.Transrectal ultrasound-guided surgical evacuation of Cesarean scar ectopic pregnancy [J].Ultrasound in Obstetrics & Gynecology,2010,35(4):481-485.
[28] WANG M,YANG Z,LI Y,et al.Conservative management of cesarean Scar pregnancies:a prospective randomized controlledtrial at a single center [J].International Journal of Clinical and Experimental Medicine,2015,8(10):18972-18980.
[29] Cheung VY.Local methotrexate injection as the first-line treatment for cesarean scar pregnancy:review of the iterature [J].J Minim Invasive Gynecol 2015,22(5):753-758.
[30] Fang Q,Sun L,Tang Y,et al.Quantitative risk assessment to guide the treatment of cesarean scar pregnancy [J].International Journal of Gynecology & Obstetrics,2017.
[31] 王乔,赵霞.剖宫产瘢痕妊娠的介入治疗及疗效评价 [J].实用妇产科杂志,2014,30(4):245-247.
[32] Huang L,Du Y,Zhao C .High-intensity focused ultrasound combined with dilatation and curettage for Cesarean scar pregnancy [J].Ultrasound in Obstetrics & Gynecology,2014,43(1):98-101.
[33] HONG Yu-feng,GUO Quan-wei,PU Ying-jie,et al.Outcome of high-intensity focused ultrasound and uterine artery embolization in the treatment and management of cesarean scar pregnancy:A retrospective study [J].Medicine,2017,96(30):e 7687.
[34] ZHANG Y,ZHANG C,HE J,et al.The impact of gestational sac size on the effectiveness and safety of high intensity focused ultrasound combined with ultrasound-guided suction curettage treatment for cesarean scar pregnancy [J].International Journal of Hyperthermia,2018,35(1):291-297.
[35] HUANG L,DU Y,ZHAO C.High-intensity focused ultrasound combined with dilatation and curettage for Cesarean scar pregnancy [J].Ultrasound in Obstetrics & Gynecology,2014,43(1):98-101.
[36] 谭莉,姜玉新.子宫剖宫产切口处早期妊娠伴胎盘植入的超声诊断和介入治疗 [J].中华超声影像学杂志,2004,3(11):27-29.
[2] Parker V L,Srinivas M .Non-tubal ectopic pregnancy [J].Archives of Gynecology and Obstetrics,2016,294(1):19-27.
[3] MAYMON R,SVIRSKY R,SMORGICK N,et al.Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy [J].Journal of Ultrasound in Medicine :Official Journal of the American Institute of Ultrasound in Medicine,2011,30(9):1179-1184.
[4] Seow KM,Huang LW,Lin YH,et al.A Cesarean scar pregnancy:issues in management [J].Ultrasound Obstet Gynecol,2004,23(3):247-253.
[5] PISKUNOVA E V.Clinical significance of office hysteroscopy in examination algorithm of partly faulty uterus scar after cesarean section on the stage of pregnancy planning [J].Journal of Minimally Invasive Gynecology,2016,22(6S):S190.
[6] LITWICKA K,GRECO E.Caesarean scar pregnancy:a review of management options [J].Current Opinion in Obstetrics & Gynecology,2011,23(6):415-421.
[7] Sel G,Sucu S,Harma M,et al.Successful management of cesarean scar pregnancy with vacuum extraction under ultrasound guidance[J].Acute Med Surg,2018,5(4):358-361.
[8] Yu HR,Kang J,Wei N,et al.Application of color Doppler ultrasound in the diagnosis and treatment of cesarean scar pregnancy after cesarean section [J].Shan Dong Yi Yao,2015 55:47.
[9] 马鹰,祝海城,何大馨.超声联合3.0 MRI在剖宫产术后切口瘢痕妊娠中诊断价值分析 [J].中国CT和MRI杂志,2017,15(4):111-113,132.
[10] OUYANG Zhenbo,YIN Qian,XU Yujing,et al.Heterotopic cesarean scar pregnancy:diagnosis,treatment,and prognosis [J].Journal of Ultrasound in Medicine :Official Journal of the American Institute of Ultrasound in Medicine,2014,33(9):1533-1537.
[11] PAS K,JOANNA S M,RENATA R,et al.Prospective study concerning 71 cases of caesarean scar endometriosis (CSE) [J].Journal of Obstetrics and Gynaecology,2017,37(6):775-778.
[12] TAKEDA A,IMOTO S,SAKAI K,et al.Three-dimensional computed tomographic angiography in the diagnosis and conservative management of cesarean scar pregnancy with prominent neovascularization [J].Taiwanese Journal of Obstetrics & Gynecology,2014,53(3):385-388.
[13] Collins K,Kothari A .Catastrophic consequences of a caesarean scar pregnancy missed on ultrasound [J].Australasian Journal of Ultrasound in Medicine,2015,18(4):150-156.
[14] WU Q-y,LING J,XUE Q,et al.Clinical analysis of diagnosis and treatment of 13 cases with cesarean scar pregnancy [J].Clinical and Experimental Obstetrics & Gynecology,2014,41(2):128-131.
[15] LIU Jie,CHAI Yi-qing,YU Yang,et al.The value of 3-dimensional color Doppler in predicting intraoperative hemorrhage for cesarean scar pregnancy [J].Medicine,2018,97(33):e 11969.
[16] GUI Ting,PENG Ping,LIU Xinyan,et al.Clinical and ultrasound parameters in prediction of excessive hemorrhage during management of cesarean scar pregnancy [J].Therapeutics and Clinical Risk Management,2017,13:807-812.
[17] RIGGS B J,COHEN J S,SHIVAKUMAR B A,et al.Doppler ultrasonography of the central retinal vessels in children with brain death [J].Pediatric Critical Care Medicine,2017,18(3):258-264.
[18] TROISI A,ORLANDI R,BARGELLINI P A,et al.Contrast-enhanced ultrasonographic characteristics of the diseased canine prostate gland [J].Theriogenology,2015,84(8):1423-1430.
[19] XIONG Xi,YAN Ping,GAO Chun-yan,et al.The value of Contrast-Enhanced ultrasound in the diagnosis of cesarean scar pregnancy [J].BioMed Research International,2016,10(8):237-250.
[20] Vial Y,Petignat P,Hohlfeld P.Pregnancy in a cesarean scar [J].Ultrasound Obstet Gynecol,2000(6),16:592-593.
[21] ZHANG Hong-wen,HUANG Jing-rui,WU Xian-qing,et al.Clinical classification and treatment of cesarean scar pregnancy [J].Journal of Obstetrics and Gynaecology Research,2017,43(4):653-661.
[22] LIN S Y,HSIEH C J,TU Yi-an,et al.New ultrasound grading system for cesarean scar pregnancy and its implications for management strategies:An observational cohort study [J].PLOS One,2018,13(8):e 0202020.
[23] 梁珍,周婷,罗满秀.彩色多普勒超声在子宫瘢痕妊娠诊断和治疗中的应用 [J].中国现代医生,2017,55(33):99-101,169.
[24] KUTUK M S,UYSAL G,DOLANBAY M,et al.Successful medical treatment of cesarean scar ectopic pregnancies with systemic multidose methotrexate:single-center experience [J].The Journal of Obstetrics and Gynaecology Research,2014,40(6):1700-1706.
[25] ZHANG Ying,DUAN Hua,CHENG Jiu-mei,et al.Treatment options to terminate persistent cesarean scar pregnancy [J].Gynecologic and Obstetric Investigation,2013,75(2):115-119.
[26] KOCHHAR P K,SARANGAL M,GUPTA U.Conservative management of cesarean scar pregnancy with uterine arteriovenous malformation:a case report [J].The Journal of Reproductive Medicine,2013,58(1/2):81-84.
[27] BIGNARDI T,CONDOUS G.Transrectal ultrasound-guided surgical evacuation of Cesarean scar ectopic pregnancy [J].Ultrasound in Obstetrics & Gynecology,2010,35(4):481-485.
[28] WANG M,YANG Z,LI Y,et al.Conservative management of cesarean Scar pregnancies:a prospective randomized controlledtrial at a single center [J].International Journal of Clinical and Experimental Medicine,2015,8(10):18972-18980.
[29] Cheung VY.Local methotrexate injection as the first-line treatment for cesarean scar pregnancy:review of the iterature [J].J Minim Invasive Gynecol 2015,22(5):753-758.
[30] Fang Q,Sun L,Tang Y,et al.Quantitative risk assessment to guide the treatment of cesarean scar pregnancy [J].International Journal of Gynecology & Obstetrics,2017.
[31] 王乔,赵霞.剖宫产瘢痕妊娠的介入治疗及疗效评价 [J].实用妇产科杂志,2014,30(4):245-247.
[32] Huang L,Du Y,Zhao C .High-intensity focused ultrasound combined with dilatation and curettage for Cesarean scar pregnancy [J].Ultrasound in Obstetrics & Gynecology,2014,43(1):98-101.
[33] HONG Yu-feng,GUO Quan-wei,PU Ying-jie,et al.Outcome of high-intensity focused ultrasound and uterine artery embolization in the treatment and management of cesarean scar pregnancy:A retrospective study [J].Medicine,2017,96(30):e 7687.
[34] ZHANG Y,ZHANG C,HE J,et al.The impact of gestational sac size on the effectiveness and safety of high intensity focused ultrasound combined with ultrasound-guided suction curettage treatment for cesarean scar pregnancy [J].International Journal of Hyperthermia,2018,35(1):291-297.
[35] HUANG L,DU Y,ZHAO C.High-intensity focused ultrasound combined with dilatation and curettage for Cesarean scar pregnancy [J].Ultrasound in Obstetrics & Gynecology,2014,43(1):98-101.
[36] 谭莉,姜玉新.子宫剖宫产切口处早期妊娠伴胎盘植入的超声诊断和介入治疗 [J].中华超声影像学杂志,2004,3(11):27-29.