Kehamilan pada Skar Seksio Sesaria

Nuswil Bernolian, Win T. Pangemanan, A. Kurdi Syamsuri, M. Hatta Ansyori, Putri Mirani, Peby Maulina Lestari, Abraham Martadiansyah, Cindy Kesty

Abstract


Tujuan: Memaparkan klasifikasi, faktor risiko, epidemiologi, cara diagnosis, tatalaksana, dan komplikasi kehamilan pada skar seksio sesarea
Metode: Tinjauan pustaka
Kesimpulan: Kehamilan pada skar SC merupakan kehamilan yang kantung kehamilannya terdapat pada miometrium yang menipis akibat SC sebelumnya. Secara umum, kehamilan pada skar Caesarean Scar Pregnancy (CSP) dapat dibedakan menjadi 2 tipe, yaitu tipe 1 (endogenik) dan tipe 2 (eksogenik). Kejadiannya berkisar antara 1 per 8.000 dan 1 per 2.500 SC dengan risiko rekurensi 3,2-5,0% pada wanita dengan riwayat SC 1 kali yang ditatalaksana dengan dilatasi dan kuretase dengan atau tanpa embolisasi arteri uterina. Adapun faktor risiko CSP adalah tebal Segmen Bawah Rahim (SBR) <5 mm, kantong kehamilan menonjol ke plika vesikouterina, SC di rumah sakit umum daerah, dan riwayat perdarahan melalui vagina ireguler dan nyeri abdomen selama CSP sebelumnya. Pengobatan CSP dapat secara konservatif dengan metotreksat (MTX) maupun operatif termasuk eksisi jaringan kehamilan dengan laparoskopi, histerotomi, atau histerektomi. Pilihan pengobatan lain termasuk dilatasi dan kuretase, reseksi transervikal (TCR) dengan histeroskopi, embolisasi arteri uterina (UEA), kemoembolisasi arteri uterina, atau penempatan kateter balon ganda.

Caesarean Scar Pregnancy

Abstract
Objective: To explain about classification, risk factors, epidemiology, diagnostic methods, management, and complications of Caesarean Scar Pregnancy (CSP).
Method: Literature review
Conclusion: CSP is a pregnancy where the gestational sac is found in the thin myometrium due to previous CS. In general, Caesarean Scar Pregnancy (CSP) can be divided into 2 types, namely type 1 (endogenic) and type 2 (exogenic). Its incidence ranges from 1 per 8,000 and 1 per 2,500 SC with a recurrence risk of 3.2-5.0% in women with a history of 1 time CS who are treated with dilatation and curettage with or without uterine artery embolization. The risk factors for CSP are lower uterine segment thickness <5 mm, gestational sac pouches protruding into the vesicouterine fold, CS in regional public hospitals, and a history of irregular vaginal bleeding and abdominal pain during previous CSP. Caesarean scar pregnancy treatment can be conservative with methotrexate (MTX) or operatively including excision of pregnancy tissue with laparoscopy, hysterotomy, or hysterectomy. Other treatment options include dilatation and curettage, transcervical resection (TCR) with hysteroscopy, uterine artery embolization (UAE), chemoembolization of the uterine arteries, or placement of a double-balloon catheter.

Key words: Caesarean scar pregnancy


Keywords


Kehamilan, seksio sesaria, skar

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References


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DOI: http://dx.doi.org/10.24198/obgynia/v3n2.198

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