The occurrence of massive hemorrhage during curettage after secondary interventional embolization for recurrent cesarean scar pregnancy and its influencing factors
10.3969/j.issn.1673-9701.2025.25.003
- VernacularTitle:复发性剖宫产瘢痕妊娠二次介入栓塞术后清宫术中大出血发生情况及其影响因素
- Author:
Jinliang CHEN
1
;
Chunbo SHI
;
An'er CHEN
Author Information
1. 宁波大学附属妇女儿童医院放射科,浙江宁波 315010
- Publication Type:Journal Article
- Keywords:
Recurrent cesarean scar pregnancy;
Interventional therapy;
Massive hemorrhage;
Influencing factor
- From:
China Modern Doctor
2025;63(25):9-12,18
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the occurrence of massive hemorrhage during curettage after secondary interventional embolization in patients with recurrent cesarean scar pregnancy(RCSP)and its related influencing factors.Methods A retrospective analysis was conducted on the clinical data of 48 patients with RCSP who were treated at Women and Children's Hospital of Ningbo University from January 2014 to December 2024.Patients were divided into massive hemorrhage group(hemorrhage volume≥200ml,n=12)and non-massive hemorrhage group(hemorrhage volume＜200ml,n=36)based on the amount of blood loss during uterine curettage.Univariate and multivariate Logistic regression analyses were used to determine the independent risk factors for massive hemorrhage during curettage after secondary interventional embolization in patients with RCSP.Results There were statistically significant differences in the number of induced abortions,the duration of amenorrhea,the level of serum β-human chorionic gonadotropin,the maximum diameter of gestational sac,the thickness of uterine scar myometrium,the fetal vascular pulsation,and the blood supply of gestational sac between two groups of patients(P＜0.05).The results of multivariate Logistic regression analysis showed that the duration of amenorrhea,the maximum diameter of gestational sac,and the thickness of uterine scar myometrium were all independent risk factors for massive hemorrhage during uterine curettage(P＜0.05).The area under the curve of duration of amenorrhea,maximum diameter of gestational sac,thickness of uterine scar myometrium and the combination of the three for predicting massive hemorrhage during curettage after secondary interventional RCSP were 0.797,0.885,0.748 and 0.914,respectively.Conclusion Patients with RCSP still have a relatively high risk of bleeding after uterine curettage following secondary interventional embolization.The duration of amenorrhea,the maximum diameter of gestational sac,and thickness of uterine scar myometrium are the key influencing factors affecting intraoperative bleeding.
