Objective:To study application effect and safety of intrauterine observation suction surgery technique in the treatment of cesarean scar pregnancy (CSP).Methods:A total of 7 patients with CSP who were treated with intrauterine observation suction surgery technique in Department of Obstetrics and Gynecology, the Second Hospital of Hebei Medical University from April 2019 to June 2022 were analyzed retrospectively. All patients used a disposable camera suction tube to observe the attraction synchronously. A disposable cervical dilator was placed 3 h before operation. Blood β-human chorionic gonadotropin (hCG) and ultrasound were reexamined 3 d after operation, and hysteroscopic treatment was supplemented if necessary.Results:Seven patients included 3 cases of type Ⅰ CSP and 4 cases of type Ⅱ CSP, the age was (33.9±4.7) years ranging from 27 to 40 years, menopause ranged from 38 d to 47 d with median time of 43 d. The operation process of all patients was smooth, the median blood loss during operation was 30 mL, the median blood loss after operation was 20 mL, the median bleeding time after operation was 3 d, and there was no uterine perforation and massive bleeding during operation. Three days after operation, blood β-hCG decreased satisfactorily in all patients. Six cases showed no pregnant tissue residue, 1 case underwent hysteroscopic resection due to strong echo with slightly rich blood flow signal at the scar site.Conclusion:With the help of the high-definition camera built into the suction tube, the observation and suction can be synchronized with the suction technique, and can be applied to the treatment of type I and some type Ⅱ CSP with menopausal time no more than 47 d.

Objective:To study application effect and safety of intrauterine observation suction surgery technique in the treatment of cesarean scar pregnancy (CSP).Methods:A total of 7 patients with CSP who were treated with intrauterine observation suction surgery technique in Department of Obstetrics and Gynecology, the Second Hospital of Hebei Medical University from April 2019 to June 2022 were analyzed retrospectively. All patients used a disposable camera suction tube to observe the attraction synchronously. A disposable cervical dilator was placed 3 h before operation. Blood β-human chorionic gonadotropin (hCG) and ultrasound were reexamined 3 d after operation, and hysteroscopic treatment was supplemented if necessary.Results:Seven patients included 3 cases of type Ⅰ CSP and 4 cases of type Ⅱ CSP, the age was (33.9±4.7) years ranging from 27 to 40 years, menopause ranged from 38 d to 47 d with median time of 43 d. The operation process of all patients was smooth, the median blood loss during operation was 30 mL, the median blood loss after operation was 20 mL, the median bleeding time after operation was 3 d, and there was no uterine perforation and massive bleeding during operation. Three days after operation, blood β-hCG decreased satisfactorily in all patients. Six cases showed no pregnant tissue residue, 1 case underwent hysteroscopic resection due to strong echo with slightly rich blood flow signal at the scar site.Conclusion:With the help of the high-definition camera built into the suction tube, the observation and suction can be synchronized with the suction technique, and can be applied to the treatment of type I and some type Ⅱ CSP with menopausal time no more than 47 d.

Objective To investigate the effects of mechanical stretch on the pelvic floor dysfunction and study the regulation of mechanical stretch on the morphology and extracellular matrix mRNA expression of fibroblasts derived from human uterosacral ligament.Methods 13 patients who underwent hysterectomy surgery due to uterine benign diseases in the Obstetric and Gynecological Department of the Second Hospital of Hebei Medical University from October 2009 to September 2010 and had no pelvic organ prolapse were recruited in this study.Fibroblasts of uterosacral ligament were cultured by collagenase digestion and identified by morphology and immunocytochemical methods.Fibroblasts of 3 ～ 4 generations were stretched by flexcell-4000 tension system for 0,4,15,24 hours.Total RNA was extracted from the fibroblasts and mRNA of Collagen Ⅰ,Collagen Ⅲ,matrix metalloproteinase-1 and tissue inhibitor of metalloprot einase-1were measured with real-time fluorescence quantitative PCR.Results In response to mechanical stretch,the morphology and orientation of the uterosacral ligament fibroblasts were changed as well as their synthetic function.Collagen Ⅰ mRNA for 4 or 15 hours' stretch (0.777 ± 0.251,0.730 ± 0.248)were statistically down regulated compared with 0 hour ( 1.000 ±0.284),( q =4.5786,4.6458,p ＜0.05).But for 24 hours'stretch,the mRNA expression ( 1.102 ±0.308) of collagen Ⅰ restored to the level of 0 hours.The expressions of collagen Ⅲ mRNA for 4,15,24 hours' stretch (4.771 ± 0.879,6.146 ± 1.109,5.022 ± 0.907 )were statistically up regulated compared with 0 hour (1.001 ± 0.284),(q =15.9481,21.7647,17.0099,P ＜ 0.01 ).MMP-1mRNA for 4,15,24 hours' stretch (6.420 ± 2.143,23.695 ± 2.221,20.169 ±2.794) were statistically up regulated compared with 0 hour ( 1.000 ±0.414),( q =9.3421,39.1178,33.0403,P ＜ 0.01 ).TIMP-1 mRNA for 4,15 hours' stretch (0.455 ± 0.370,0.481 ± 0.386)were statistically down regulated compared with 0 hour( 1.000 ± 0.425 ),( q =6.5265,6.3106,P ＜0.05).But for 24 hours'stretch,the mRNA expression( 0.883 ± 0.538 ) restored to the level of 0 hours.Conclusions The morphology,orientation and the synthesis function of the uterosacral ligament fibroblasts can be regulated by mechanical stress.Extracellular matrix remodeling may be adaptive changes due to the mechanical stress.