Effect Of Different Regimens In The Treatment Of Cesarean Scar Pregnancy

Objectives To study the effects of different methods for treating cesarean scar pregnancy(CSP),and evaluate the efficacy and disadvantages of different methods.Methods The patients who were diagnosed as CSP and hospitalized in North China Science and Technology University Affiliated Hospital from January 2011 to February 2020 were collected.According to the different treatment methods,the patients who were treated with vacuum aspiration under ultrasound guidance were selected as group A.The patients who were treated with uterine arterial embolization combined with ultrasoundguided vacuum aspiration were selected as group B,while the patients treated with pregnancy lesion resection by operation were selected as group C.The data such as human chorionic gonadotropin(HCG)level and decrease rate of HCG value were collected.Their hospitalization days as well as cost were recorded..Results 1 There were differences among the three groups of patients in terms of intraoperative blood loss,operation time,decrease rate of HCG value,postoperative hemoglobin reduction value,hospitalization days,cost,time when the HCG value drops to normal(P<0.05).The intraoperative blood loss,operation time,decrease rate of HCG value in the group C were higher than those in group A and B(P<0.05).The decrease of hemoglobin in group B was less than that in groups A and C(P<0.05).the length of hospital stay and the cost of hospitalization in group A were shorter than those in groups B and C(P<0.05);the length of time when the HCG value drops to normal in group C was shorter than that in groups A and B(P<0.05).2 The treatment success rate in group A was 91.9%,in group B was 90.9%,in group C was 100.0%.There was no significant difference in the success rates of the three methods.3 Among all type Ⅰ CSP,the intraoperative blood loss and postoperative hemoglobin drop values were greater in group A than in group B,and the differences were statistically significant(P<0.05);the hospitalization days and hospitalization costs were higher in group B than in group A.The difference was statistically significant(P<0.05).In all type Ⅱ CSP,the intraoperative blood loss and postoperative hemoglobin drop values were greater in group A than in group B,and the differences were statistically significant(P<0.05);the hospitalization days and hospitalization costs were higher in group B than in group A.The difference was statistically significant(P<0.05).4 The serum HCG value before treatment and the proportion of rich blood flow around pregnancy lesions in the failure group were higher than those in the success group,and the thickness of the muscular layer at the scar was lower than that in the success group,the difference was statistically significant(P<0.05);multifactor Logisitic regression analysis,serum HCG value before treatment and abundant blood flow around pregnancy lesions finally enter the regression equation(P<0.05),and OR>1.Conclusions 1 For different types of CSP,ultrasound-guided vacuum aspiration,uterine arterial embolization combined with ultrasound-guided vacuum aspiration,and pregnancy lesion resection have a high success rate for cesarean scar pregnancy.2 The vacuum aspiration under ultrasound guidance has a high success rate,and has the advantages of short operation time,fast recovery,and low cost.It is the preferred method for type Ⅰ CSP.For type Ⅱ CSP,uterine artery embolization combined with ultrasound-guided vacuum aspiration can reduce blood loss and reduce the risk of heavy bleeding;3 Patients need to be monitored serum HCG and ultrasound after treatment,and take remedial measures in time if there is any abnormality.4 Serum HCG value before treatment and blood flow around lesions are factors that affect the failure of treatment.Figure5;Table16;Reference113...