瘢痕子宫再妊娠的孕前评估与处理  

Pre-pregnaney evaluation and management of scarred uterus re-pregnancy

作　　者：吴章鑫 吴郁[1] Wu Zhangxin;Wu Yu

机构地区：[1]北京大学第三医院妇产科,100191

出　　处：《中华产科急救电子杂志》2025年第1期8-14,共7页Chinese Journal of Obstetric Emergency(Electronic Edition)

基　　金：首都卫生发展科研专项(2024-1-4094)。

摘　　要：本文探讨了瘢痕子宫再妊娠的孕前评估与处理策略,强调了准确评估子宫瘢痕愈合情况的重要性,同时提出一系列孕前评估方法和处理措施;文中讨论了影响剖宫产及子宫肌瘤剔除术后瘢痕愈合的多种因素,并提出相应的评估方法,如经阴道超声、宫腔超声造影、磁共振成像和宫腔镜检查等。此外,还介绍了剖宫产瘢痕憩室的临床分级,为临床决策提供了参考,对于剖宫产瘢痕愈合不良的手术处理,也给出了建议。This article comprehensively examines prenatal assessment and treatment strategies for re-pregnancy in the context of a scarred uterus.It underscores the significance of accurately evaluating the healing status of uterine scars and proposes a series of pre-pregnancy assessment methods and treatment interventions.The discussion delves into the various factors influencing scar healing following cesarean sections and myomectomies,and recommends corresponding assessment techniques,including transvaginal ultrasound,hysteroscopic contrast ultrasound,magnetic resonance imaging,and hysteroscopy.Furthermore,the article introduces a clinical grading system for cesarean scar diverticulum,which is a valuable reference for clinical decision-making.Additionally,it offers suggestions for the surgical management of poorly healing cesarean scars.

关 键 词：子宫 瘢痕 剖宫产术 子宫肌瘤切除术 憩室 孕前保健 

分 类 号：R71[医药卫生—妇产科学]