ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ HÌNH ẢNH CHỤP MẠCH SỐ HOÁ XOÁ NỀN CỦA BỆNH NHÂN CHỬA VẾT MỔ

Abstract

Objective: Cesarean Scar Pregnancy (CSP) is a condition in which the gestational sac implants at a previous cesarean section scar, posing risks of massive hemorrhage and uterine rupture, which can be life-threatening. This study aims to describe the clinical, paraclinical characteristics, and Digital Subtraction Angiography (DSA) imaging findings of CSP patients to optimize treatment strategies. Methods: A cross-sectional study was conducted on 37 CSP patients (grade III-IV) who underwent uterine artery embolization at the Center for Diagnostic Imaging – Nuclear Medicine, Viet Duc Friendship Hospital. Clinical symptoms, laboratory findings, Doppler ultrasound, and DSA imaging before and after embolization were analyzed. Results: Among the patients, 52.8% were asymptomatic, 43.2% had vaginal bleeding, and 8.1% experienced abdominal pain. The mean beta-hCG level was 66.604 ± 59.828 mIU/mL. Doppler ultrasound detected increased vascularity in all cases, with 45.9% showing high vascularization and 16.2% having penetrating vessels. DSA imaging revealed that all cases had blood supply from bilateral uterine arteries, with 10.8% having unilateral dominance. The CSP blood supply classification based on DSA findings was as follows: grade 1 (48.6%), grade 2 (27.0%), and grade 3 (24.3%). Conclusion: CSP presents with diverse clinical manifestations. Transvaginal ultrasound remains the primary diagnostic tool, while DSA provides detailed insights into the blood supply to the gestational sac, supporting effective embolization planning.