Clinical comparison of four treatment methods for cesarean scar pregnancy
10.3969/j.issn.1673-4254.2015.12.24
- VernacularTitle:剖宫产瘢痕部位妊娠的四种治疗方法的临床效果
- Author:
Chunli LIN
1
;
Xiangling LIAO
;
Lan NIE
;
Xiaocui CHEN
Author Information
1. 湖南省妇幼保健院妇一科
- Keywords:
cesarean scar pregnancy;
uterine curettage;
interventional therapy;
methotrexate
- From:
Journal of Southern Medical University
2015;(12):1787-1791
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the best approach to treatment of cesarean scar pregnancy (CSP). Methods A total of 138 patients with CSP treated between January and December, 2013 were retrospectively analyzed. The patients were treated with conservative drug therapy, direct curettage, uterine curettage after embolization, or open or transvaginal surgery. The amount of blood loss, proportion of patients with blooding loss greater than 50 mL, hospitalization days, and hospitalization expenses were compared among the groups. Results The median volume of blood loss was 370 mL in the conservative treatment group, 59 mL in direct curettage group, 67 mL in interventional therapy group, and 1425 mL in the surgical group, and the proportion of patients with blood loss over 50 mL was 76.9%, 38.8%, 27.5%, and 100%in the 4 groups, respectively. The midian hospital stay of the 4 groups was 9.0, 4.0, 6.0 and 10.0 days, with median hospitalization expenses of 12281.0, 3843.5, 14805.0, and 17202.2 RMB Yuan, respectively. All these data were significantly different among the 4 groups (P<0.05). Conclusions Direct curettage surgery should be encouraged for treatment of CSP. Embolization therapy can reduce the risk of bleeding but is associated with potential complications and more costly, and should be performed with caution. Open or trasnvaginal surgery can be considered in difficult cases of CSP, and its combination with interventional therapy is an option to better preserving the uterus.
