Objectives: To evaluate the ultrasonic characteristic of Caesarean scar pregnancy in anterior wall of the lower segment of the uterus by transabdominal and transvaginal three dimensional ultrasound and its guiding value for clinical treatment.
Methods:The clinical data of 28 CSP diagnosed by transabdominal and transvaginal three dimensional ultrasound were retrospectively analysed. Under transabdominal and transvaginal two-dimensional and three dimensional ultrasound, it can be clearly displayed that the boundary and the relation of spatial relation between gestation sac and Caesarean scar, the thickness of muscle layer and the continuation of the perimetrium in Caesarean scar, the blood distribution of the internal and peripheral gestation sac and the situation of uterine cavity, cervix uteri etc. Results: There were not gestation sacs in uterine cavities of 28 CSP, but it could be seen in Caesarean scares. In terms of ultrasonic characteristics, there were 14 CSP which had the gestation sac only in Caesarean scar, 4 CSP which only had clutter echoic mass in Caesarean scar, 7 CSP which had segmental gestation sac in both Caesarean scar and the other in tuterine cavity, which looked like water drop or eggplant and 3 CSP which had segmental gestation sac in Caesarean scar and the other in cervix uteri, which looked like water drop or eggplant. In all of 28 CSP, the anterior wall of the lower segment of the uterus had a ''wedge'' change. The boundary between gestation sac and Caesarean scar was not clear, while the thickness of muscle layer in Caesarean scar was very thin. The blood flow signals were all concentrated in Caesarean scar and mostly rich.
Conclusions:The relationship between gestation sac and Caesarean scar can be more clearly found by transabdominal and transvaginal colour Doppler flow imaging and three dimensional ultrasound which also could make localised and qualitative diagnosis as soon as possible and provide a reliable basis for clinical treatment and judging curative effect.
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