Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị thai bám sẹo mổ lấy thai tại Bệnh viện Phụ sản Hải Phòng

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Tác giả: Văn Đức Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Khoa học Sức khỏe, 2024

Mô tả vật lý: tr.66

Bộ sưu tập: Metadata

ID: 341920

Thêm vào giỏ Liên kết toàn văn

Nghiên cứu mô tả cắt ngang nhằm mục tiêu: (1) Mô tả đặc điểm lâm sàng, cận lâm sàng của các trường hợp thai bám sẹo mổ lấy thai tại Bệnh viện Phụ sản Hải Phòng. (2) Nhận xét kết quả xử trí thai bám ở sẹo mổ lấy thai ở những thai phụ trên. Đối tượng nghiên cứu: bao gồm các thai phụ có thai bám tại sẹo mổ lấy thai được chẩn đoán và xử trí tại Bệnh viện Phụ Sản Hải Phòng. Kết quả: Triệu chứng lâm sàng: ra máu âm đạo: 20,8%, đau bụng vùng hạ vị: 12,5%, không biểu hiện triệu chứng lâm sàng: 33,3%
Triệu chứng cận lâm sàng: 63,5% bệnh nhân có phân nhóm Cross-over sign(COS): COS-1, 26,0% thuộc nhóm COS-2+ và 10,4% thuộc nhóm COS-2-
66,7% có tăng sinh mạch tại kênh vết mổ
Kết quả điều trị: Trong các trường hợp COS-1 có tăng sinh mạch, hút buồng tử cung có tỉ lệ thành công là 92,9%
nút mạch kết hợp nội soi buồng tử cung có tỉ lệ thành công 100%. Tất cả các trường hợp COS-2 và các trường hợp không tăng sinh mạch đều điều trị thành công mà không xảy ra biến chứng gì. Kết luận: Thai bám sẹo mổ lấy thai có triệu chứng lâm sàng không đặc hiệu. Nút mạch kết hợp nội soi buồng tử cung bước đầu cho kết quả điều trị tốt hơn với các trường hợp COS-1 và có tăng sinh mạch.Objectives: (1) Describe the clinical, subclinical manifestations of patients who have cesarean scar pregnancy at Hai Phong Hospital of Obstetrics and Gynecology. (2) Give comments on treatment outcomes of cesarean scar pregnancy of these patients. Method: A descriptive cross-sectional study of the women with cesarean scar pregnancy diagnosed and treated at Hai Phong Hospital of Obstetrics and Gynecology. Results: Clinical symptoms: vaginal bleeding: 20.8%, lower abdominal pain: 12.5%, asymptomatic: 33.3%. Subclinical findings: 63.5% of cases is Cross-over sign 1 category (COS-1)
26.0% of cases is COS-2+ and 10.4% is COS-2-. 66.7% of cases had increased angiogenesis at the cesarean scar defect. Treatment outcomes: in COS-1 group which had increased angiogenesis, dilatation and curettage had succeeded in 92.9% of all, the combination of uterine artery embolization and hysteroscopy had succeeded in 100%. All the patients in COS-2 category and non-angiogenesis had treated successfully without complications. Conclusions: Cesarean scar pregnancy has non-specific clinical symptoms. Treatment by the combination of uterine artery embolization and hysteroscopy initially gave better outcomes in COS-1 with increased angiogenesis group.

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