Uterine Artery Chemoembolization in the Treatment of Cesarean Scar Pregnancy_West China Medical Journal

Authors：

HUANG Liping , LIANG Ailin ,  LIU Hui

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Hui, Email: ahuangliping@163.com

Keywords：

剖宫产; 子宫切口妊娠; 子宫动脉化疗栓塞术; 清宫术; 甲氨蝶呤

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目的　探讨子宫动脉化疗栓塞在剖宫产术后子宫切口妊娠治疗中的可行性和安全性。方法　回顾分析2006年7月－2011年3月收治的152例剖宫产切口瘢痕妊娠行介入治疗的病例资料。结果　152例子宫动脉化疗栓塞操作均成功。阴道大出血或不规则出血均得到有效控制。人绒毛膜促性腺激素β亚型较术前下降，差异有统计学意义（Z=−9.295，P=0.000），术后2～22 d行清宫术，术中失血3～100 mL，平均27 mL。3例行子宫切除术，子宫切除率2%。1例发生栓子脱落导致左下肢胫前动脉栓塞并发症。结论　子宫动脉化疗栓塞治疗剖宫产术后切口妊娠可有效控制大出血、降低清宫风险、降低子宫切除风险，是治疗切口妊娠的有效可行方法之一。

Citation： HUANG Liping,LIANG Ailin,LIU Hui. Uterine Artery Chemoembolization in the Treatment of Cesarean Scar Pregnancy. West China Medical Journal, 2012, 27(3): 360-362. doi: Copy

1.	Moschos E, Sreenasasimhaiah S, Twicklcr DM. First-trimester diagnosis of cesarean scar ectopic pregnancy[J]. J Clini Ultras, 2008, 36(8): 504-511.
2.	Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnencies[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
3.	Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
4.	Arruda Mde S, de Camargo Júnior HS. Cesarean scar ectopic pregnancy: a case report[J]. Rev Bras Ginecol Obstet, 2008, 30(10): 518-523.
5.	杨小芸, 刘兴会. 剖宫产切口瘢痕妊娠临床特点及治疗进展[J]. 中国实用妇科与产科杂志, 2010, 26(8): 585.
6.	Larsen JV. Solomon MH. Pregn ancy in a uterine seasacculus-an unusual cause of postabortal haemorrhage[J]. S Afr Med J, 1978, 53(4): 142-143.
7.	Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication[J]. Hum Reprod Update, 2004, 10(6): 515-523.
8.	Chen HY, Chen SJ, Hsieh FJ. Observation of cesarean section scar by transvaginal ultrasonography[J]. Ultrasound Med Biol, 1990, 16(5): 443-447.
9.	焦光琼, 凌梅立, 钱尚萍. 经阴道彩色多普勒超声在诊断剖宫产子宫疤痕妊娠中的价值[J]. 上海医学影像, 2004, 13(1): 16-18.
10.	Vial Y, Petignat P, Holfeld P. Pregnancy in a cesaream scar[J]. Ultracound Obstet Gynecol, 2000, 16(6): 592-593.
11.	庄亚玲, 韦浪花, 王雯黄, 等. 应用子宫动脉栓塞术治疗剖宫产瘢痕处妊娠[J]. 2008, 88(33): 2372-2374.
12.	Godin PA, Bassil S, Donnez XJ. An ectopic pregnancy developing in a previous caesarian section scar[J]. Fertil Steri, l997, 67(2): 398-400.
13.	张燕科, 吴瑞瑾, 林俊. 剖宫产术后子宫瘢痕处妊娠的早期诊断与治疗[J]. 实用妇产科杂志, 2009, 25(12): 750-752.
14.	Deans R, Abbott J. Hysteroscopic management of cesarean scar ectopic pregnancy[J]. Fertil Steril, 2010, 93(6): 1735-1740.
15.	Sugawara J, Senoo M, Chisaka H, et al. Successful conservative treatment of a cesarean scar pregnancy with uterine artery embolization[J]. Tohoku J Exp Med, 2005, 206(3): 261-265.
16.	Zhuang Y, Huang L. Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar[J]. Am J Obstet Gynecol, 2009, 201(2): 152. e1-3.

1. 　Moschos E, Sreenasasimhaiah S, Twicklcr DM. First-trimester diagnosis of cesarean scar ectopic pregnancy[J]. J Clini Ultras, 2008, 36(8): 504-511.
2. 　Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnencies[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
3. 　Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management[J]. Ultrasound Obstet Gynecol, 2004, 23(3): 247-253.
4. 　Arruda Mde S, de Camargo Júnior HS. Cesarean scar ectopic pregnancy: a case report[J]. Rev Bras Ginecol Obstet, 2008, 30(10): 518-523.
5. 　杨小芸, 刘兴会. 剖宫产切口瘢痕妊娠临床特点及治疗进展[J]. 中国实用妇科与产科杂志, 2010, 26(8): 585.
6. 　Larsen JV. Solomon MH. Pregn ancy in a uterine seasacculus-an unusual cause of postabortal haemorrhage[J]. S Afr Med J, 1978, 53(4): 142-143.
7. 　Maymon R, Halperin R, Mendlovic S, et al. Ectopic pregnancies in a caesarean scar: review of the medical approach to an iatrogenic complication[J]. Hum Reprod Update, 2004, 10(6): 515-523.
8. 　Chen HY, Chen SJ, Hsieh FJ. Observation of cesarean section scar by transvaginal ultrasonography[J]. Ultrasound Med Biol, 1990, 16(5): 443-447.
9. 　焦光琼, 凌梅立, 钱尚萍. 经阴道彩色多普勒超声在诊断剖宫产子宫疤痕妊娠中的价值[J]. 上海医学影像, 2004, 13(1): 16-18.
10. 　Vial Y, Petignat P, Holfeld P. Pregnancy in a cesaream scar[J]. Ultracound Obstet Gynecol, 2000, 16(6): 592-593.
11. 　庄亚玲, 韦浪花, 王雯黄, 等. 应用子宫动脉栓塞术治疗剖宫产瘢痕处妊娠[J]. 2008, 88(33): 2372-2374.
12. 　Godin PA, Bassil S, Donnez XJ. An ectopic pregnancy developing in a previous caesarian section scar[J]. Fertil Steri, l997, 67(2): 398-400.
13. 　张燕科, 吴瑞瑾, 林俊. 剖宫产术后子宫瘢痕处妊娠的早期诊断与治疗[J]. 实用妇产科杂志, 2009, 25(12): 750-752.
14. 　Deans R, Abbott J. Hysteroscopic management of cesarean scar ectopic pregnancy[J]. Fertil Steril, 2010, 93(6): 1735-1740.
15. 　Sugawara J, Senoo M, Chisaka H, et al. Successful conservative treatment of a cesarean scar pregnancy with uterine artery embolization[J]. Tohoku J Exp Med, 2005, 206(3): 261-265.
16. 　Zhuang Y, Huang L. Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar[J]. Am J Obstet Gynecol, 2009, 201(2): 152. e1-3.

West China Medical Journal

Uterine Artery Chemoembolization in the Treatment of Cesarean Scar Pregnancy

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