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Различный подход к консервативному органосохраняющему лечению шеечной беременности в зависимости от результатов ультразвукового исследования с цветовым доплеровским картированием

Различный подход к консервативному органосохраняющему лечению шеечной беременности в зависимости от результатов ультразвукового исследования с цветовым доплеровским картированием

Abstract

12 cases of differentiated organ preservation treatment of cervical pregnancy using proprietory diagnostic techniques and treatment are presented. Ultrasonic criteria of the chorion invasion incase of cervical pregnancy were revealed (unclear boundary of chorion, thickening of the chorion, reducing its echogenisity, visualization of blood flow in the chorion in B-mode, increase of blood flow in CDI, thinning of cervix). In 3 cases the signs of chorion invasion were found, and patients were successfully carried out a combination of minimally invasive organ-preserving methods of treatment (uterine arteries embolisation with intra-arterial injection of methotrexate and introduction of methotrexatein thegestational sac), leaving the dead gestational sac in the cervix that afterwards resolved within three months. In 9 cases there were no signs of chorion invasion; in 4 cases there was conducted successful removal of gestational sac after preliminary uterine arteries embolisation; in 5 cases gestational sac was successfully removed in usual manner without prior uterine arteries embolization under conditions of operationroom.

Представлены 12 случаев дифференцированного органосохраняющего лечения шеечной беременности с использованием собственных методик диагностики и лечения. Выявлены ультразвуковые критерии вращения хориона при шеечной беременности (нечеткость границ хориона, утолщение хориона, снижение его эхогенности, визуализация движения крови в хорионе в В-режиме, резкое усиление кровотока при ЦДК, истончение шейки). В 3 случаях признаки вращения хориона были обнаружены, и пациенткам был успешно проведен комплекс малоинвазивных органосохраняющих методов лечения (эмболизация маточных артерий с внутриартериальным введением метотрексата и введением метотрексата в плодное яйцо) с оставлением замершего плодного яйца в шейке, которое впоследствии рассосалось в течение 3 месяцев. В 9 случаях признаков вращения хориона не было, из них в 4 случаях было проведено успешное удаление плодного яйца после предварительной эмболизации маточных артерий (ЭМА), в 5 случаях плодное яйцо с успехом удалено обычным способом без предварительной ЭМА в условиях развернутой операционной.

Keywords

ШЕЕЧНАЯ БЕРЕМЕННОСТЬ, ВРАЩЕНИЕ ХОРИОНА, УЛЬТРАЗВУКОВЫЕ ИССЛЕДОВАНИЯ, ЦДК, ЭМБОЛИЗАЦИЯ МАТОЧНЫХ АРТЕРИЙ, МЕТОТРЕКСАТ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
bronze