Clinical Value about the Analysis of Ultrasound Imaging of Cesarean Scar Pregnancy by Transvaginal Ultrasonography

Objective:To evaluate the value of diagnosis of cesarean scar pregnancy by analysis the ultrasound imaging.Methods:The transvaginal ultrasound imaging of 40 patients with cesarean scar pregnancy and their clinical treatments were retrospectively analyzed.Results:①The manifestation of cesarean scar pregnancy in 40 cases were classified into 3 types on transvaginal ultrasound characters:gestational sac type(6 cases),vacuolar type (9 cases) and substantive lump type (25 cases). The manifestation of color doppler flow imaging(CDFI) were classified into color abundant (15 cases),color little and colorless (20 and 5 cases respectively).Most color doppler abundant cases manifested high speed and low resistant frequency spectrum in CDFI(87%,resistance index RI0.5).②We classified all cases into 4 grades according to the relationship between the gestational sac or mass and the myometrium. 5 cases in grade 0 were successfully treated by expectant treatment. Out of 18 cases in grade 1,17 cases were successfully treated by expectant treatment and the other case was treated by lesion resection and uterus neoplasty. Out of 13 cases in grade 2,11 cases were successfully treated by expectant treatment,one case was treated by hysterectomy and one case was uterus neoplasty. Out of the 4 cases in grade 3,3 cases were treated by hysterectomyand one case was uterus neoplasty. Conclusions:The characters of transvaginal ultrasound imaging provide the evidence for correct diagnosis of cesarean scar pregnancy. The relationship between the gestational sac or mass and the myometrium in the ultrasound imaging,and the results of color dopplor profit the proper choice of clinical treatment.