ORIGINAL ARTICLE   

Minerva Surgery 2021 December;76(6):580-5

DOI: 10.23736/S2724-5691.20.08412-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

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, China

BACKGROUND: The aim of this study was 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 artery embolization; High-intensity focused ultrasound ablation; Curettage; Laparotomy