Analysis Of Factors Influencing Re-reproduction After Uterine Artery Embolization Combined With Hysteroscopic Lesion Excision For Cesarean Scar Pregnancy

Objective: To investigate the factors influencing re-reproduction after uterine artery embolization(UAE)combined with hysteroscopic lesion excision for cesarean scar pregnancy(CSP).Methods: From January 2016 to December 2018,312 CSP patients who had the intention to reproduce again after UAE combined treatment at the First Affiliated Hospital of Xinjiang Medical University were selected as the research objects and the reproductive outcomes were followed up and various indicators before and after treatment were obtained.The patients were divided into pregnancy group and non-pregnancy group according to the presence or absence of re-pregnancy,and delivery group and non-delivery group according to the presence or absence of re-delivery after re-pregnancy.Multivariate logistic regression model was used to analyze the factors affecting re-reproduction.Results: Among the 312 patients,216 conceived again and 96 were infertile.114 of the conceived patients delivered at full term and 102 did not deliver eventually.Multivariate logistic regression analysis revealed that age≥ 34 years,number of abortions > 2,time from last cesarean section ≤ 3years,thickness of the lower segment of the uterine muscle ≤ 3 mm,vaginal bleeding,combined uterine fibroids and adenomyosis,pain and numbness in the hip and lower limbs,and menstrual recovery time > 40 days or changes from the previous menstruation were independent risk factors for re-pregnancy(P < 0.05);age ≥ 34 years,hysteroscopic operation time > 60 minutes,and post-embolization syndrome were independent risk factors for re-delivery(P < 0.05).Conclusion: There is a certain infertility rate and adverse pregnancy rate after UAE combined treatment for CSP,and there are several high risk factors affecting re-reproduction.