剖宫产瘢痕妊娠1例临床报告

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY
Slaoui Aziz, B. Aicha, Tayeb Roughaya, Zeraidi Najia, Lakhdar Amina, Baydada Aziz, Kharbach Aicha
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引用次数: 0

摘要

背景:在不同形式的异位妊娠中,剖宫产瘢痕妊娠是最不常见的妊娠之一,估计发生率为1/1800。它是大出血的主要风险,一旦确诊就需要积极治疗,因为它会影响患者的功能预后(子宫切除术),但也可能危及生命。对于不再希望生育、血流动力学不稳定和/或药物治疗失败的患者,最初通常建议采用不同的手术技术。病例介绍:我们在此报告一例19岁的年轻患者,无特殊病史,妊娠2段,5个月前因胎儿心律异常剖宫产后生下一名活婴,在闭经6周时诊断为剖宫产妊娠疤痕,在本医院急诊室就诊。她成功地管理与肌肉注射甲氨蝶呤。接下来的事情平淡无奇。结论:剖宫产术后瘢痕着床妊娠越来越常见。其后果可能是戏剧性的,从子宫切除术到危及生命的出血,临床医生必须熟悉这种病理实体,并为其管理做好准备。后者必须是快速的,并允许,如有必要,保存病人的生育能力。从这个意义上说,在没有禁忌症的情况下,应建议甲氨蝶呤注射保守治疗作为一线治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cesarean scar pregnancy: A clinical case report
Background: Among the different forms of ectopic pregnancy, cesarean scar pregnancy is one of the most uncommon with an estimated incidence of 1/1800 pregnancies. A major risk of massive hemorrhage, it requires active management as soon as it is diagnosed because it can affect the functional prognosis of the patient (hysterectomy) but can also be life-threatening. Different surgical techniques are generally proposed in first intention to patients who no longer wish to have children, who are hemodynamically unstable and/or in case of failure of medical treatment. Case presentation: We hereby report the case of a young 19-year-old patient with no particular medical history, gravida 2 para 1 with a live child born after a cesarean section for fetal heart rhythm abnormalities during labor 5 months earlier and who presented to the emergency room of our structure for the management of a cesarean pregnancy scar diagnosed at 6 weeks of amenorrhea. She was successfully managed with an intramuscular injection of methotrexate. The follow-up was uneventful. Conclusion: The implantation of a pregnancy on a cesarean section scar is becoming more and more frequent. With consequences that can be dramatic, ranging from hysterectomy to life-threatening hemorrhage, clinicians must be familiar with this pathological entity and be prepared for its management. The latter must be rapid and allow, if necessary, the preservation of the patient's fertility. In this sense, conservative medical treatment with methotrexate injections should be proposed as a first-line treatment in the absence of contraindication.
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来源期刊
Journal of Clinical Obstetrics and Gynecology
Journal of Clinical Obstetrics and Gynecology Medicine-Obstetrics and Gynecology
CiteScore
0.30
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8
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