Evaluation of the Clinical Effect of High-Intensity Focused Ultrasound and Drug Conservative on the Treatment of Cesarean Scar Pregnancy
- VernacularTitle:高强度聚焦超声与药物保守治疗对剖宫产瘢痕部位妊娠的临床效果评价
- Author:
Liping LIU
1
,
2
;
Xiangxi ZHOU
;
Mingxia ZHANG
;
Ligang WANG
;
Junshu LI
;
Changqing PAN
;
Yong ZHANG
Author Information
1. 绵阳市中心医院电子科技大学医学院附属绵阳医院妇产科,四川绵阳 621000
2. 重庆市妇幼保健院妇产科,重庆 400010
- Keywords:
Cesarean scar pregnancy;
High-intensity focused ultrasound;
Methotrexate;
Mifepristone
- From:
Journal of Practical Obstetrics and Gynecology
2023;39(11):870-874
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical effect of high-intensity focused ultrasound(HIFU)and drug con-servative treatment on the treatment of type Ⅰ and type Ⅱ cesarean scar pregnancy(CSP).Methods:A retrospec-tive analysis was performed on 191 patients diagnosed with type Ⅰ and type Ⅱ CSP by ultrasonography and trea-ted in Mianyang Central Hospital from January 2018 to December 2021,and they were divided into drug group(n=67)and HIFU group(n=124)according to different treatment methods before curettage surgery.After receiv-ing conservative drug treatment or HIFU treatment,preformnegative pressure suction curettage under ultrasound monitoring to evaluate the effectiveness and safety of the two pretreatment methods.Results:There were no sig-nificant differences in age,number of cesarean sections,gestational age,the maximum diameter of the gestational sac,number of incision pregnancies,the β-hCG level before pretreatment,the heart tube pulse in the gestational sac,size of fetal bud,and fertility requirements between the medication group and HIFU group(P＞0.05).The proportion of type Ⅱ incision in HIFU group was higher than that in drug group(P＜Q.05).There were no signifi-cant differences between the two groups in intraoperative bleeding,treatment outcome effective rate after pretreat-ment,postoperative vaginal bleeding duration,postoperative uterine cavity residual,rate of reoperation and rate of repregnancy(P＞0.05).There were statistical differences between the two groups in the operation time of curet-tage surgery,whether the operation method was changed after pre-treatment,total hospital stay,β-hCG recovery time and hospitalization cost(P＜0.05).Following up to November 2022,there were 12 cases re-pregnancies in the drug group and 16 cases re-pregnancies in the HIFU group.Conclusions:For type Ⅰ and type Ⅱ CSP,HIFU pretreatment before negative pressure suction curettage under ultrasound monitoring is a safe and effective treat-ment,which improves the treatment effect and reduces the hospitalization time of patients.It may be an effective clinical therapy for type Ⅰ and type Ⅱ CSP treatment.
