The best treatment period for scar pregnancy has these symptoms

Scar pregnancy is extremely harmful. When scar pregnancy is suspected, it is necessary to pay attention to it and the diagnosis should be cautious. You can consult an experienced doctor and perform a vaginal B-ultrasound examination, because vaginal B-ultrasound is more accurate than abdominal B-ultrasound. If it is a scar pregnancy, termination of pregnancy is recommended, but the pregnant woman has a strong desire to have a baby. We observed her for 1-2 weeks and then rechecked the ultrasound to rule out scar pregnancy and eventually give birth at full term.

1. What are the clinical manifestations of uterine scar pregnancy?

She had a history of cesarean section before, and this pregnancy was accompanied by irregular vaginal bleeding. Vaginal bleeding can be more or less, sometimes sudden heavy bleeding, and sometimes no vaginal bleeding. There is usually no obvious abdominal pain, or only mild abdominal pain. Asymptomatic people are easily missed.

2. How to diagnose uterine scar pregnancy?

B-ultrasound is currently the preferred method for diagnosing scar pregnancy. B-ultrasound examination is greatly affected by the doctor's experience, and there is a possibility of missed diagnosis as well as misdiagnosis. Currently, due to the doctors' attention to this disease, missed diagnosis is rare, and misdiagnosis has a tendency to gradually increase. The so-called misdiagnosis is to mistake a pregnancy in which the gestational sac is close to the cervix as a scar pregnancy, resulting in unnecessary treatment. When scar pregnancy is suspected, it is necessary to pay attention to it and the diagnosis should be cautious. You can consult an experienced doctor and perform a vaginal B-ultrasound examination, because vaginal B-ultrasound is more accurate than abdominal B-ultrasound. If you are still not sure, you can have an MRI examination. MRI examination is clearer than B-ultrasound examination, but it is more expensive. When the diagnosis is unclear, dynamic B-ultrasound monitoring is also reasonable. As the gestational sac grows and the uterus increases in size, the diagnosis becomes more accurate. We have seen many cases where other hospitals diagnosed scar pregnancy and recommended termination of pregnancy, but the pregnant women had a strong desire to have children. We observed them for 1-2 weeks and then rechecked them by B-ultrasound, which ruled out scar pregnancy and eventually led to full-term delivery. We believe that when B-ultrasound suspects scars, it is necessary to pay attention to them and do not rush to deal with them when they cannot be diagnosed.

3. How to treat uterine scar pregnancy?

Since scars can have serious adverse consequences, pregnancy must be terminated promptly once diagnosed. There is currently no unified treatment plan.

1. Drug treatment

Methotrexate and mifepristone are currently commonly used drugs. The purpose is to stop the development of the embryo and reduce the blood supply to the placenta, thereby reducing bleeding during medical abortion or surgery. Methotrexate is a chemotherapy drug with many side effects, some of which can cause severe bone marrow suppression. We tend to use mifepristone plus traditional Chinese medicine for treatment. After 1-2 weeks of use, most embryos stop developing and the blood supply to the placenta is significantly reduced. Misoprostol is then used for abortion or uterine curettage, which is mostly successful with low cost and minimal trauma.

2. Uterine artery embolization

It is an interventional treatment method that performs unilateral or bilateral uterine artery embolization via the femoral artery, followed by elective uterine curettage. This method is relatively expensive, has many side effects of embolization, and the timing of uterine curettage is difficult to grasp.

3. Surgical treatment

Through laparotomy or minimally invasive surgery: local lesion resection + uterine repair, + hysterectomy if necessary. Surgical treatment is safe and effective, but it is traumatic and expensive, so it should not be used as the first choice and can only be used as a supplement when other methods are ineffective.