Application Of High Intensity Focused Ultrasound In Treatment Of Cesarean Scar Pregnancy

Objective:This paper investigates the curative efficacy of high intensity focused ultrasound(HIFU) method on cesarean section scar pregnancy (CSP), in order to find a safer andmore effective treatment for CSP.Methods:The clinical data of220treated cases with CSP, collected from Jan.2008andDec.2012, is retrospectively analyzed and divided into three groups:Drugs treatmentgroup, in which48cases were treated with MTX or Mifepristone;Interventiontreatment group, in which142cases were treated by curettage after UAE;HIFUtreatment group, in which30cases were voluntarily treated by HIFU.Three groupswere combined with curettage.All the patients have been followed up. This threegroups are compared to each other in terms of effectiveness, β-HCG recovery time,the average duration of hospital stays, the average cost and the amount of vaginalbleeding in curettage. In addition, the effect of HIFU treatment on lowering bloodβ-HCG level and vascular resistance index(RI) around lesion is statistically analyzed.Results:This three treatments have almost the same efficiency(P>0.05), while the bloodβ-HCG recovery time after treatment, the average duration of hospital stays, theaverage cost, and the amount of vaginal bleeding in curettage are of significantdifference (P<0.05). Drugs treatment group has the second longest β-HCG recoverytime, the least average cost, the longest average durations of hospital stays, and thelargest amount of vaginal bleeding. Intervention treatment group has the shortestβ-HCG recovery time, the most average cost, the second longest average duration ofhospital stays, and the second largest amount of vaginal bleeding. HIFU treatmentgroup has the longest blood β-HCG recovery time, the second least average cost, theshortest average duration of stay and the fewest amount of vaginal bleeding. In HIFU treatment group, compared to the blood β-HCG level prior to treatment,there exist significant differences (P<0.05) with that of one week and four weeks after,which is statistically meaningful. It means that HIFU can lower the level of bloodβ-HCG, and kill the gestational sac. The same results could be got in terms of thevascular resistance index (RI) around lesion. HIFU can make microvascular aroundCSP lesion blocked once it is injured, so that the bleeding decreases or evendisappears.Conclusions:1. Among the three treatments, HIFU treatment has the characteristics of lesscost and shortest hospital stay.2. Among the three treatments, patients treated by HIFU bleed least.3. Among the three treatments, HIFU treatment has the characteristics of littledamage and safety.4. As a new treatment of CSP, HIFU is effective and safe in clinical treatment.