Clinical Analysis on Bilateral Uterine Artery Chemoembolization for Caesarean Scar Pregnancy_West China Medical Journal

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Department of Obstetrics and Gynecology, Affiliated Hospital of North Sichuan Medical College. Nanchong, Sichuan 637000, P.R.China;

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Keywords：

子宫动脉; 化疗栓塞; 剖宫产切口妊娠

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【摘要】目的 探讨双侧子宫动脉化疗栓塞术治疗剖宫产子宫切口妊娠的临床应用价值。方法 2004年3月-2009年10月确诊剖宫产子宫切口妊娠的患者25例。首先行双侧子宫动脉超选择插管，注入甲氨喋岭，再用明胶海绵条栓塞双侧子宫动脉，48~72 h内在B型超声监测下行清宫术。结果 25例子宫动脉化疗栓塞术后复查B型超声，提示孕囊血供明显减少。22例在B型超声监测下一次性清除胚胎组织，出血量少；2例因胚胎植入肌层突向浆膜层栓塞术后加用氟尿嘧啶，未行清宫，自行排出；1例因术后切口处形成大血肿行手术治疗。结论双侧子宫动脉化疗栓塞术是治疗剖宫产子宫切口妊娠一种有效方法，既保留子宫，又保留其生育功能。
【Abstract】 Objective To evaluate the application of bilateral uterine artery chemoembolization for caesarean scar pregnancy (CSP）. Methods A total of 25 patients with CSP From March 2004 to October 2009 were selected. Bilateral uterine artery super selective catheterization was performed after injection with methotrexate, and gelatin sponge granules were injected into blateral uterine artery. Then atificial abortion was performed under B-ultrasonic scanning within 48-72 hours. Results In all 25 cases, the blood flow of the embryo decreased significantly after uterine artery chemoembolization. A total of 22 patients received artificial abortion successfully with little vaginal bleeding;two pateints received medication with 5-FU duet to the embryo near to the perimetrium, and finally the embryo expulsed spontaneously;one patient underwent hysterectomy, because a huge hematoma was formed at the incision of the uterus after uterine artery chemoembolization. Conclusion Bilateral uterine artery chemoembolization is effective for CSP, which could keep the uterus and the patients’ reproductive function.

Citation： FAN Bo,JING Qiao,HUANG Jin. Clinical Analysis on Bilateral Uterine Artery Chemoembolization for Caesarean Scar Pregnancy. West China Medical Journal, 2010, 25(9): 1649-1650. doi: Copy

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1. Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnencies [J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
2. Vial Y, Petignat P, Hohlfeld P. Pregnancy in a cesarean scar [J]. Ultrasound Obstet Gynecol, 2000, 16(6): 592-593.
3. 张桂兰, 周留林. 子宫瘢痕处早期妊娠8例治疗体会[J]. 医学理论与实践, 2008, 21(12): 1444-1445.
4. 高桂芹. 剖宫产子宫瘢痕妊娠的诊断与治疗进展[J]. 国际妇产科学杂志, 2008, 35(1): 15-18.
5. Roberts H, Kohlenber C, Lanzarone V, et al. Ectopic pregnancy in lower segment uterine scar[J]. Aust NZ J Obstet Gynecol, 1998, 38(1): 114-116.
6. Flystra DL, Pound-Chang T, Miller MG, et al. Ectopic pregnancy within a cesarean delivery scar areviem[J]. Obstet Gynecol Surv, 2002, 57(8): 537-543.
7. 范光升, 刘欣艳, 金力, 等. 介入技术在终止剖宫产后子宫下段瘢痕早期妊娠的应用[J]. 中国计划生育学杂志, 2005, 119(9): 545-546.

West China Medical Journal

Clinical Analysis on Bilateral Uterine Artery Chemoembolization for Caesarean Scar Pregnancy

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