【摘要】目的 探讨剖宫产术后瘢痕处妊娠的临床特征、诊断和治疗方法。 方法 回顾分析18例剖宫产瘢痕处妊娠病例的临床表现、检查和治疗方法。 结果 18例妊娠均经B超确诊， 94.4 %(17/18)经甲氨蝶呤联合米非司酮加清宫术保守治疗成功，1例因误诊为不全流产，行清宫术，术中大出血行子宫切除术。 结论 剖宫产史妇女再次妊娠时，孕早期应常规行阴道超声检查，有助于明确诊断;甲氨蝶呤联合米非司酮加清宫术是治疗剖宫产瘢痕妊娠的主要方法，可有效避免子宫切除。

    【关键词】剖宫产术; 瘢痕妊娠; 诊断; 治疗

    【Abstract】Objective To describe the clinical characteristics, diagnosis, the method of treatment of cesarean scar pregnancy (CSP). Methods Retrospective analysis of 18 cases of CSP. Clinical presentations, ultrasound examinations, and treatment methods were analyzed. Results All 18 cases of CSP were diagnosed by B ultrasound, of which 1 case (5.6 %) misdiagnosed as incomplete abortion. Hemorrhage occurred during dilatation and curettage, and hysterectomy was then performed. All other 17 cases (94.4 %) were treated with dilatation and curettage, along with methotrexat and mifepristone. Conclusion For pregnancies after cesarean section, transvaginal ultrasonography should be routinely performed. Color Doppler helps confirm the diagnosis. Curettage with methotrexate and mifepristone are effective in reducing the risk of hysterectomy. ......