Application Of Standardized Ultrasound In The Diagnosis And Treatment Of Cesarean Section Scar Pregnancy

Objective:In recent years,with the cesarean section rate increased significantly,clinical and ultrasound physicians on the cesarean section scar pregnancy increased the degree of attention,cesarean section scar pregnancy increased year by year.Because of its early non-specific clinical manifestations,clinical treatment is also diversified,color Doppler ultrasound,magnetic resonance and other auxiliary examination in its diagnosis and treatment play a key role.Because of the high cost and poor reproducibility of magnetic resonance imaging,standardized ultrasound is particularly important.Ultrasonography can clearly show the location of the pregnancy,the scope and blood perfusion,etc.,and can be early and timely diagnosis,as far as possible to avoid misdiagnosis.Clinical treatment of diversification,there is no uniform treatment,so this study will explore the standardization of ultrasound in the diagnosis of cesarean section scar clinical application value.Method:A total of 78 patients were retrospectively analyzed from January 2013 to August 2015 for cesarean section scar pregnancy in Nanjing Drum Tower Hospital.Ultrasonography methods:transvaginal ultrasonography,if necessary,combined with abdominal ultrasound.Transvaginal examination,the patient emptying the bladder,take the stone position,focusing on the size of the specimen,shape,implantation position,and the cesarean section scar at the myometrial level is clear,and measure the lower uterine segment of the myometrial scar thickness,the color doppler flow imaging observed within the pregnant women,the surrounding blood perfusion,especially pregnant women and uterine anterior wall of the scar between the blood flow,focusing on the relationship between pregnant women and the anterior inferior uterine scar,the thickness of the lower part of the anterior wall of the scar and the peripheral blood flow of pregnancy to the uterine wall thickness of the anterior wall of the lower part of the basis for treatment.Clinical treatment methods include uterine surgery,hysteroscopy,laparoscopic surgery,uterine artery embolization,or combined surgery,laparoscopic monitoring or ultrasound to confirm the accuracy of CSP.All patients track their clinical outcome.Result:1,according to cesarean section postoperative scar pregnancy type group:gestational sac:a total of 58 cases,the success rate of direct curettage 74.1%(43 cases/58 cases).The success rate of direct curettage was 25.0%(5 cases/20 cases).There was significant difference between the two groups(?2 = 15.171,P<0.001).2,gestational sac scar pregnancy:ultrasound prompted the edge of the gestational sac from the uterine serous layer thickness ? 2mm,you can try the ultrasound monitoring under the palace surgery;3,mass-type scar pregnancy:the group of patients mostly CSP that curettaged incompletely or aborted incompletely after the continued growth of pregnancy tissue formation,therefore,ultrasound manifestation of mass-type patients,clinical generally do not recommend the choice of direct curettage,abdominal or laparosc opic resection and repair of lesions.Conclusion:1,ultrasound in the cesarean section after the diagnosis of scar pregnancy play a key role.2,standardized ultrasound can effectively improve the accuracy of abnormal pregnancy detection,reduce missed diagnosis,while the clinical intervention measures,the evaluation of therapeutic effect has important reference value and guiding significance.