A Comparison of Transvaginal Removal and Repair of Uterine Defect for Type II Cesarean Scar Pregnancy and Uterine Artery Embolization Combined With Curettage

Frontiers in Medicine

article

Shanshan Cao¹  Guijing Qiu¹  Peipei Zhang¹  Xinyan Wang²  Qing Wu² 

[1] Tiantai People's Hospital of Zhejiang Province;Department of Gynecology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College

关键词: cesarean scar pregnancy;    uterine artery embolization;    SAC;    transvaginal sugery;    methotrexate;   

DOI  :  10.3389/fmed.2021.654956

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: There is no consensus on a standardized therapy for type II cesarean scar pregnancy (CSP II). The objective of the present study was to evaluate the efficacy and safety and compare costs associated with transvaginal removal and repair (TRR) of uterine defect for CSP II to those of uterine artery embolization (UAE) and curettage. Methods: We conducted a retrospective study that included 87 patients diagnosed with CSP II and treated by performing UAE in combination with curettage and hysteroscopy ( n = 53), or TRR ( n = 34). Clinical data and outcomes were analyzed. Results: UAE and TRR groups exhibited similar success rates. The TRR group had significantly lower complication rates (30.19 vs. 8.82%, P < 0.05) and lower total costs (13,765.89 ± 2,029.12 vs. 9,063.82 ± 954.67, P < 0.05) than the UAE group. The anterior myometrium of the lower uterine segment was relatively thicker after performing TRR, and no patient suffered from recurrent CSP II. The proportion of patients in the TRR group who had full-term delivery without uterine rupture was 88.24% (30/34), while four patients failed to pregnancy. Conclusion: TRR is a safe and effective treatment method for patients with CSP II and presents a highly cost-effective outcome, especially for patients with future fertility desire.

【 授权许可】

CC BY