Abstract
Objective: This study aims to retrospectively analyze the clinical curative effects of surgery, uterine artery embolization (UAE), and high-intensity focused ultrasound (HIFU) in order to provide the theory and evidences for selecting the optimal treatment for cesarean scar pregnancy (CSP).Methods: Women with CSP were treated with surgery (laparoscopic, hysteroscopy, and hysteroscopy–laparoscopic surgery), UAE combined with curettage, and HIFU combined with curettage. The general conditions and therapeutic effects, including vital signs during the operation, discomfort of discharge, cure rate, total blood loss, decline in the rate of hCG, and hospital stay, were compared and analyzed.Results: For the 154 CSP patients, the cure rate of surgery (n = 95) was 97.89%, the cure rate of UAE (n = 32) was 43.74%, and the cure rate of HIFU (n = 27) was 70.37%. The difference was statistically significant (P < 0.05). Furthermore, the hCG level of surgical patients quickly declined, whereas HIFU slowly declined. The difference between the decline rate of hCG and mean hospitalization time was statistically significant (P < 0.05). UAE was good for CSP with gestational age <60 days and diameter of gestational sac <40 mm. Furthermore, HIFU was well for CSP patients with a gestational age of <55 days and a gestational sac diameter of <30 mm. Surgery was suitable for any type of these cases.Conclusion: CSP patients with short gestational age and small gestational sac can be treated with surgery, UAE, and HIFU, and achieve safe and effective therapeutic effects. Surgery is also a good choice for CSP for patients with a long gestational age, a large gestational sac diameter, high levels of hCG, or an ample blood supply.
Highlights
Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, which was first described by Larsen and Solomon [1]
The aim of the present study was to compare and analyze the clinical curative effects of surgery, uterine artery embolization (UAE) combined with curettage, and High-intensity focused ultrasound (HIFU) combined with curettage in the management of CSP, and provide the theory and evidences for selecting the optimal treatment for CSP
HIFU was well for CSP patients with a gestational age of
Summary
Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, which was first described by Larsen and Solomon [1]. Mothers with CSP are confronted with risks, such as unpredictable life-threatening massive bleeding and uterine rupture, when misdiagnosed [4]. There is an urgent need to perform an early accurate diagnosis and select the optimal treatment for CSP, in order to avoid hysterectomy due to uterine rupture and life-threatening massive bleeding [5]. Conservative treatment entails the systemic or local administration of medication, curettage, and uterine artery embolization (UAE). These methods may lead to uncontrollable massive hemorrhage and hysterectomy. Along with the development and widespread application of minimally invasive surgery, it would be beneficial to treat CSP by laparoscopy and hysteroscopy, since this can reduce surgical trauma and shorten postoperative recovery time [7, 8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
