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Minerva Chirurgica 2020 Jul 16

DOI: 10.23736/S0026-4733.20.08412-6


language: English

Efficacy of different treatment of 134 cases of cesarean scar pregnancy

Wenjian ZHANG, Yan LIU, Yaling JIANG, Xinhua YUAN, Xiujie SHENG

Guangzhou Institute of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R.China


BACKGROUND: To compare the clinical efficacy of different methods for treating cesarean scar pregnancy (CSP).
METHODS: The clinical data of 134 patients diagnosed with CSP in the Third Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. Grouped by treatment plan: pretreatments +ultrasound guided Curettage group (group A), pretreatments+ laparotomy (group B). Group A was sub-grouped according to the pretreatments: ultrasound guided uterine evacuation (A1), uterine arterial embolism (UAE) + ultrasound guided uterine evacuation (A2), high-intensity focused ultrasound (HIFU) + ultrasound guided uterine evacuation (A3); Group B was sub-groups according to pretreatments: laparotomy (B1), UAE + laparotomy (B2) .
RESULTS: The success rates of treatment in groups A and B were 72.73%、100%, and it was statistically significant (P <0.05) There were no statistically significant in the blood loss and the degree of decrease of β - hCG in these two group (P > 0.05). The operation time, length of stay and cost were statistically significant between curettage group and laparotomy group (P < 0.05); there was no significant difference in the degree of β-HCG decrease (%) and surgical bleeding volume. The success rate in group A1-A3 was 64.10%, 96.52% and 100% respectively, which was statistically significant (P < 0.05). No statistically significant were showed in operation time, Length of stay and the degree of decrease of β - hCG within 5 days after operation in A1-A3 group (P > 0.05). The blood loss and cost between A1 and A3 groups were statistically significant (P < 0.05). The success rate in group B1-B2 were both 100%, with no statistically significant (P> 0.05). There were no statistically significant in operation time, blood loss, degree of decrease of β- hCG, length of stay between the two groups (P > 0.05). The cost between the two groups was statistically significant (P < 0.05).
CONCLUSIONS: Ultrasound-guided uterine Curettage can be used as a better treatment for type I and II scar pregnancy. UAE or HIFU before Curettage can reduce uterine bleeding, while UAE before the laparotomy did not reduce uterine bleeding.

KEY WORDS: Uterine scar pregnancy; Uterine artery embolization; High-intensity focused ultrasound; Curettage; Laparotomy

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