Clinical efficacy analysis of different therapeutic methods in patients with cesarean scar pregnancy

Yan Wu,Lei-Fang Sun,Ya-Nan Si,Xiao-Li Luan,Yong-Mei Gao

doi:10.1016/j.tjog.2021.03.019

Yan Wu, Lei-Fang Sun + Show 3 more

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https://doi.org/10.1016/j.tjog.2021.03.019

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Abstract

ObjectiveThe purpose of this study was to analyze the clinical efficacy of five therapeutic strategies in patients with CSP. Materials and methodsA total of 135 CSP patients were included and divided into five groups based on the treatment they received, including transvaginal resection (Group A), laparoscopic resection (Group B), uterine arterial embolization (UAE) combined with hysteroscopic curettage (Group C), UAE combined with uterine curettage (Group D), and hysteroscopic curettage (Group E). To investigate the clinical efficacy of these strategies, intraoperative bleeding, serum β-hCG levels and recovery time, menstruation recovery time, hormone levels at 1 month after treatment. ResultsPatients in group A had the lowest postoperative serum β-hCG levels, and the shortest recovery times of both serum β-hCG and menstruation, followed by patients in group B. Group C and D had small amount of blood loss. The hospital stays and costs were low in group E. In addition, the sex hormone levels showed no significant difference among the five groups. ConclusionOur results indicated that resection surgery and UAE have good curative effects, but high hospital costs in CSP treatment. The selection of an optimal treatment regimen for CSP should be carried out based on specific conditions of the patients.

Highlights

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy with a serious life-threatening situation [1]
A total of 135 CSP patients were included in our research and divided into five groups based on the treatment they received, including transvaginal resection (Group A), laparoscopic resection (Group B), uterine arterial embolization (UAE) combined with hysteroscopic curettage (Group C), UAE combined with uterine curettage (Group D), and hysteroscopic curettage (Group E)
Our results indicated that resection surgery and UAE have good curative effects, but high hospital costs in CSP treatment

Summary

Introduction

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy with a serious life-threatening situation [1]. It was first described in the study in 1978, and immediately becomes an important clinical challenge over the last 10 years [2]. CSP is considered a long-term complication in the patients received a cesarean section. It is different from cervical, tubal or other types of ectopic pregnancies, and 1 case can be identified among 2500 ~ 8000 cesarean sections [6]. Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy with a serious lifethreatening situation.

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