Cesarean scar pregnancy. Current state of the problem. Diagnostics. Clinical symptoms. Medical tactics
Objective. To carry out a systematic analysis of the data which is available in modern literature, concerning prevalence, etiology, pathogenesis, diagnostics and treatment of cesarean scar pregnancy (CSP) and possible complications.Tskhay V.B., Vergunov N.A., Yametov P.K.
Subject and methods. The review included foreign and Russian publications which entered the Pub med database on this subject. Length of search covered 15 years.
Results. Modern data on prevalence, etiology and pathogenesis of CSP are submitted. Value of risk factors is reflected in the development of CSP and its complications. Value of transvaginal scanning in combination with dopplerometry is specified at early diagnostics of BRM as rather reliable method. Efficiency and low number of complications at the use of combined treatment methods is demonstrated: systemic application of Methotrexate, carrying out a laparoscopy together with a hysteroresektoskopy.
Conclusion. Frequency of CSP grows together with the frequency of operation of Cesarean section. The effective organosafe treatment provides fertility, and decreases a number of serious complications and critical situations perhaps only at timely diagnostics on early term of gestation. The comparative assessment of efficiency of the combined surgical and medication treatment is presented in separate publications. However, almost total absence of information on CSP in domestic special literature, absence of uniform algorithm of diagnostics and treatment, can lead to mistakes of obstetricians-gynecologists both in diagnostics, and in tactics of maintaining pregnant women with this pathology.
Keywords
Кеу words: cesarean section
methotrexate
caesarean scar pregnancy
ectopic pregnancy
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Received 16.08.2016
Accepted 02.09.2016
About the Authors
Vitaly B. Tskhay, MD, prof., head of the Department of perinatology, obstetrics and gynecology, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University.660022, Russia, Krasnoyarsk, Partizana Zheleznyaka str. 1. Tel.: +79232872134. E-mail: tchai@yandex.ru
Pavel K. Yametov, assistant of the Department of perinatology, obstetrics and gynecology, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University.
660022, Russia, Krasnoyarsk, Partizana Zheleznyaka str. 1. Tel.: +79509782527. E-mail: mail.rur@mail.ru
Nikita A. Vergunov, postgraduater of the Department of perinatology, obstetrics and gynecology, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University.
660022, Russia, Krasnoyarsk, Partizana Zheleznyaka str. 1. Tel.: +79676124502. E-mail: vergunov.n@gmail.com
For citations: Tskhay V.B., Vergunov N.A., Yametov P.K. Cesarean scar pregnancy.
Current state of the problem. Diagnostics. Clinical symptoms. Medical tactics.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (3): 5-10. (in Russian)
http://dx.doi.org/10.18565/aig.2017.3.5-10
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