帝王切開瘢痕部妊娠にTLHを施行した一例

抄録

  Cesarean scar pregnancy (CSP) reportedly accounts for 6.1% of all ectopic pregnancies in women with a history of at least one Cesarean section delivery. Because of the increasing incidence of Cesarean section deliveries, the number of reported patients with CSP has increased over time. Fertility-sparing treatments for CSP include uterine artery embolization, local methotrexate injection, and laparoscopic or open surgery, while hysterectomy is one treatment for women who do not wish to preserve fertility. Here we report the case of a 39-year-old woman who developed CSP 18 years after a Cesarean section delivery, and underwent total laparoscopic hysterectomy.
  The patient presented at 8 weeks of gestation with symptoms of CSP. Because she wanted an abortion, she and her partner requested a hysterectomy. We subsequently performed total laparoscopic hysterectomy at 8 weeks and 5 days of gestation. Her postoperative course was uneventful, and she was discharged 5 days after surgery.