一時的に腹腔鏡下子宮動脈結紮術を行い、子宮鏡下に胎嚢除去術を施行した帝王切開瘢痕部妊娠の1例

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Objective: To present a case of cesarean scar pregnancy（CSP）undergoing a hysteroscopic resection of the villi following temporal laparoscopic uterine artery ligationCase: A 31-year-old woman, with a past history of two cesarean sections, presented a chief complaint of irregular vaginal bleeding. The diagnosis of CSP was made by ultrasonography when a gestational sac was detected in the area of the cesarean scar. In addition, an examination of contrasted computed tomography showed that the gestational sac was depicted in the same area. The level of serum hCG was 2694mIU/ml. We laparoscopically ligated uterine arteries on both sides with vessel tapes. The villi were confirmed to be located in the cesarean section scar portion. We completely resected the villi through a hysteroscope. No bleeding from the scar section appeared after the ligations of the uterine arteries were released. The serum hCG level rapidly decreased in the postoperative period. It was demonstrated that the procedures shown here could be safely performed as a treatment for CSP.
日本産科婦人科内視鏡学会の論文