Summary Of Clinical Data Of High Intensity Focused Ultrasound In The Treatment Of Cesarean Scar Pregnancy

Objective:Clinical observation of high intensity focused ultrasound in the treatment of type II and type I cesarean scar pregnancy with gestational weeks > 8 weeks.Methods:124 patients with CSP treated in the first hospital of Shanxi Medical University from January 2017 to October 2021 were collected and analyzed retrospectively.According to different pretreatment methods,they were classified into HIFU group(n= 34),uterine artery embolization group(n = 40)and drug group(n = 50).The amount of bleeding,the decrease rate of human chorionic gonadotropin value,the clinical cure rate,the length of hospital stay,the cost of hospital stay,the incidence of complications and adverse events(postoperative fever,massive bleeding and lower abdominal pain),the duration of postoperative vaginal bleeding,the time of menstrual rehydration,the decrease of menstrual volume and the recurrence of CSP were compared among the three groups.Results:1.HIFU group had shorter hospitalization time,lower hospitalization expenses,less postoperative fever 、 lower abdominal pain and reduced menstrual volume compared with UAE group,and had less bleeding during uterine curettage,higher decline rate of serum HCG value and clinical cure rate,fewer hemorrhage events and less postoperative vaginal bleeding time compared with the drug group,and the difference was statistically significant(P < 0.05).2.In patients with massive hemorrhage,the proportion of patients with mass >5cm and serum HCG value > 100000 m IU/ml were 81.82% and 81.82% respectively;Among the patients with mass > 5cm and serum HCG value > 100000 m IU/ml,the proportion of patients with massive hemorrhage was 69.23% and 28.13% respectively.Conclusion:1.HIFU has good clinical effect,economic safety and less complications in the treatment of type II and type I CSP with gestational weeks > 8 weeks.2.For patients with larger mass or higher serum HCG value,uterine curettage after pretreatment cannot effectively reduce the risk of massive bleeding in CSP,so a safer and more effective treatment should be selected.