剖宫产术后子宫瘢痕妊娠期待妊娠结局的研究进展  

Research progress on the expected pregnancy outcome of uterine scar pregnancy after cesarean sectio

作　　者：曾帅 陈练[1] Zeng Shuai;Chen Lian

机构地区：[1]北京大学第三医院妇产科国家产科专业医疗质量控制中心,国家妇产疾病临床医学研究中心,女性生育力促进全国重点实验室,辅助生殖教育部重点实验室(北京大学),100191

出　　处：《中华产科急救电子杂志》2025年第1期31-36,共6页Chinese Journal of Obstetric Emergency(Electronic Edition)

基　　金：国家重点研发计划(2022YFC2704503);国家自然科学基金(82101821);首都卫生发展科研专项(首发2024-1-4094)。

摘　　要：随着剖宫产术后再妊娠人群的增多,剖宫产术后子宫瘢痕妊娠(cesarean scar pregnancy,CSP)的发生率也随之升高。虽然国内外的指南和共识均建议CSP一旦诊断应立即终止妊娠,但部分CSP孕妇因各种原因要求继续妊娠。由于CSP期待妊娠发生不良妊娠结局风险较大,亟待综合相关文献加深认识。本文回顾了近20年的文献,归纳了CSP期待妊娠的结局,总结了孕早期超声征象和胎盘植入、产后出血、子宫破裂、子宫切除等风险的关系,探讨了期待妊娠的分娩时机和分娩方式,以期为CSP的临床管理提供更多的参考和依据。As the number of pregnant women with previous cesareans continues to grow,so too does the incidence of cesarean scar pregnancy(CSP).Domestic and international guidelines and consensus recommend that a CSP should be terminated once diagnosed.Nevertheless,some pregnant women diagnosed with CSP request to continue the pregnancy for various reasons.Given the significant risks of adverse pregnancy outcomes associated with continuing a CSP,there is a pressing need to enhance our understanding of the relevant literature.The present study undertook a review of the literature on continuing a CSP over the past two decades,to generalize the outcomes of pregnancies.In addition,the association between ultrasound signs in the first trimester and the risks of placenta accreta spectrum disorders,postpartum hemorrhage,uterine rupture,and hysterectomy was also summarized.Furthermore,the appropriate time and method for terminating a CSP after expectancy were discussed.The present review aims to provide more references for better management of CSP.

关 键 词：子宫 瘢痕 剖宫产术 妊娠 观察性等待 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]