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目的：探讨剖宫产瘢痕部位妊娠的围手术期并发症及母儿预后。方法：选取2008年11月－2014年11月观察治疗的剖宫产瘢痕部位妊娠孕产妇60 例做回顾性分析研究。其中A 组31例：瘢痕部位妊娠早期（妊娠第13周末之前）出现阴道流血；B 组18例：瘢痕部位妊娠中期（妊娠第14 ~ 27 周末）出现阴道流血，并发胎盘前置状态；C 组11 例：瘢痕部位妊娠晚期妊娠周期达28周及其后，并发凶险性前置胎盘或伴有胎盘植入。分析剖宫产瘢痕部位妊娠孕产妇的围手术期并发症及母儿预后。结果：3 组孕产妇的妊娠周期分别为：（9 ± 4.5）w 、（20.5 ± 6.5）w 、（32.5 ± 5.5）w ，3 组患者均有不同程度的出血，孕产妇出血量及失血严重程度和瘢痕部位妊娠的妊娠周数有关，妊娠周数越大，并发症越多，孕产妇的出血越严重，需要输血的病例越多，输血量越大。60例孕产妇中有27例发生产科大出血，A 组6 例，B 组10例，C 组11例；出现子宫破裂征兆有15例，A 组5 例，B 组7 例，C 组3 例；瘢痕部位妊娠至中期孕产妇（B 组）出现胎盘前置状态，瘢痕部位妊娠至晚期孕产妇（C 组）出现凶险性前置胎盘。所有病例中，行子宫切除术11例，其中A 组有2 例， B组有4 例，C 组5 例。C 组产妇发生产科大出血人数、出血量、输血量和子宫切除率明显高于A 组、B 组，组间比较差异具有统计学意义（P < 0.05）结论：剖宫产瘢痕部位妊娠极容易并发子宫破裂及凶险性前置胎盘以及胎盘植入，增加产妇大出血的风险，孕产妇切除子宫的概率高。争取做到早期诊断，早期治疗剖宫产瘢痕部位妊娠可减少出血和并发症的发生，治疗前及术前需准备充足血量，做好输血准备，降低围手术期风险。
Objective: To investigate the perioperative complications and maternal and child prognosis of cesarean scar pregnancy. Methods: A retrospective analysis of 60 pregnant women in cesarean scar from November 2008 to November 2014 was performed. Among 31 cases in group A, vaginal bleeding occurred in early pregnancy (before the 13th week of gestation) in the scar site; in group B, vaginal bleeding occurred in the second trimester (between the 14th and 27th week of gestation) in pregnancy; group C Eleven cases: scar site pregnancy stage after pregnancy for up to 28 weeks and thereafter, accompanied by dangerous placenta previa or placenta accreta. Analysis of Perioperative Complications and Maternal and Childhood Prognosis of Pregnant Maternal in Cesarean Section. Results: The pregnancy rates of the three groups were (9 ± 4.5) w, (20.5 ± 6.5) w and (32.5 ± 5.5) w, respectively. All three groups had different degrees of bleeding, maternal bleeding and severe blood loss The extent and gestational weeks of pregnancy related to the number of scar pregnancy, the larger the number of weeks of pregnancy, the more complications, the more serious the bleeding of pregnant women, the more cases need blood transfusion, the greater the volume of blood transfusion. There were 27 maternal obstetric hemorrhage occurred in 60 cases, A group of 6 cases, B group of 10 cases, C group of 11 cases; signs of uterine rupture in 15 cases, A group of 5 cases, B group of 7 cases, C group of 3 cases; Pregnancy to the mid-term scar in pregnant women (group B) placenta previa, scar site pregnancy to the late pregnant women (C group) appeared dangerous placenta previa. In all cases, 11 cases underwent hysterectomy, including 2 cases in group A, 4 cases in group B and 5 cases in group C. The number of maternity bleeding, blood loss, blood transfusion and hysterectomy in group C were significantly higher than those in group A and group B (P <0.05) .Conclusions: Pregnancy in cesarean section is extremely complicated Uterine rupture and precancerous placenta accreta and placenta accreta, increase the risk of maternal bleeding, the probability of maternal removal of the uterus high. To achieve early diagnosis and early treatment of cesarean section scar pregnancy can reduce the occurrence of bleeding and complications before and preoperative need to prepare adequate blood to prepare for blood transfusion to reduce perioperative risk.