摘要
目的 探讨超声在子宫剖宫产切口处早期妊娠伴胎盘植入的诊断和保守治疗中的作用。 方法 分析11例子宫剖宫产切口处早期妊娠伴胎盘植入的诊治经过,总结其声像图特点。临床表现为人 工流产术后阴道不规则出血7例,停经4例,均行经阴道超声检查。8例行血管造影检查及子宫动脉栓塞 及清宫或切除子宫。3例于超声引导下向胎囊内注射氨甲喋呤(MTX)。结果 7例人工流产术后超声显 示子宫前壁下段混合回声区,周边及内部血流信号丰富,呈高速低阻型,阻力指数(RI)<0.6,诊断为胎盘 植入。4例停经者超声检查显示子宫前壁下段胎囊,诊断为子宫剖宫产切口处早孕伴瘢痕种植。治疗后全 部病灶内血流信号明显减少,RI>0.6。结论 超声检查是诊断子宫剖宫产切口处早期妊娠伴胎盘植入的 主要方法,它对该病的保守治疗具有较大的帮助。
Objective To discuss the role of ultrasonography in the diagnosis and conservative management for pregnancy within a cesarean delivery scar with placenta increta in first trimester. Methods Eleven patients of caesarean scar pregnancy with placenta increta in the first trimester were studied, in which 7 patients had irregular vaginal bleeding after artificial abortion, and 4 patients had amenorrhea. They all received transvaginal ultrasound. Digital subtractive angiography(DSA) and uterine arteries embolization(UAE) and suction curettage or hysterectomy were performed in 8 patients. Methothrexate(MTX) was administered locally under ultrasonographic guidance in 3 patients. Results In 7 patients after abortion, ultrasound detected complex texture in front wall at the lower uterine segment, with massive internal and peripheral color signals of high velocity and low resistance index(RI). The diagnosis of placenta increta was made. In another 4 patients, a gestational sac was demonstrated in the anterior lower uterine segment in ultrasound. The diagnosis of a gestation in the scar of a caesarian section was made. After treatment, color signals in all lesions decreased remarkably and RI> 0.6. Conclusions Ultrasonography plays an important role in the diagnosis and conservative therapy of pregnancy within a cesarean delivery scar with placenta increta.
出处
《中华超声影像学杂志》
CSCD
2004年第11期828-830,共3页
Chinese Journal of Ultrasonography
