Clinical Analysis Of49Cases Of Cesarean Scar Pregnancy

Objective: Analysis of the effect of different treatment methods forthe treatment of cesarean scar pregnancy, and provide a reasonable basisfor clinical diagnosis and treatment.Method: Collected from January2010to May2014at the FirstHospital of Jilin University hospital delivery of maternal5709people.4311people were cesarean deliveries,1398people were naturalchildbirth,803people were scar uterus,49people were diagnosed withcesarean scar pregnancy.The cesarean scar pregnancy rate was0.86%,accounting for6.10%of scar uterine.Discuss on clinical data about49cases of cesarean scar pregnancy in a retrospective way.And divideinto reasonable groups according to different treatments.To make theclinical data for reasonable group discussions and statistical processing.Group A:20cases of uterine artery embolization in combination withmethotrexate topical and elective hysteroscopic resection oflesions(wealthy people who don’t have fertility requirements).Group B:11cases of hysteroscopic resection of lesions combinedwith intrauterine balloon compression(people who don’t have fertilityrequirements,in poor economic conditions and the bloodHCG≤50000mIU/L).Group C:10cases of drugs to kill the embryo combined ysteroscopicresection of lesions and intrauterine balloon compression (people whodon’t have fertility requirements,in poor economic conditions and theblood HCG＞50000mIU/L).Group D:8cases of abdominal lesion resection(people who have fertility requirements).Results：1.The age,gestational age,number of cesarean delivery,the timefrom the last cesarean delivery,gestational sac size,hemoglobin offour groups show no significant statistical difference(P>0.05).2. The morbidity of cesarean scar pregnancy is increasing year afteryear.3.The average operative time of group A、B、C、D are37.35min、66.64min、46.00min、127.87min.The operative time of groupA、B、C are less than that of group D(P<0.05).4.The average postoperative hospital stay of group A、B、C、D are2.10d、2.27d、3.00d、5.63d.The postoperative hospital stay of group A、B、C are less than that of group D(P<0.05).5.The average blood loss of group A、B、C、D are14.75ml、279.09ml、174.00ml、1112.50ml.The blood loss of group A、B、C are lessthan that of group D(P<0.05).6. The average transfusion of group A、B、C、D are0.50U、1.18U、0.60U、4.38U.The transfusion of group A、B、C are less than that of groupD(P <0.05).7.The average treatment costs of group A、 B、 C、 D are22511.33yuan、14449.61yuan、17514.91yuan、18811.44yuan.Thetreatment costs of four groups show no significant statisticaldifference(P>0.05).8.1year after cesarean section,the incidence of cesarean scarpregnancy is highest,prevalence decreased thereafter.9.A, B, C, D group treatment success rate was no significant difference (P>0.05)Conclusion：1.The morbidity of cesarean scar pregnancy is incr-easing year after year.2.1year after cesarean section,the incidenceof cesarean scar pregnancy is highest,prevalence decreased thereafte-r.3.Therapeutic method is different according to the situation of p-atients, and each patient should be given an specific one.4.Strictlycontrol the indications for cesarean section,reduce the rate of cesare-an section, after cesarean section strictly contraception2-3years, double uterine suture, pre pregnancy examination (review of gynecologi-cal ultrasound)assessment of cesarean scar recovery status (if thereis endometrial defects,it should be treated by operation before pregn-ancy), health education (popularization of the knowledge of recurren-t abortion damage to the endometrial).There are the effective measu-res to reduce the cesarean scar pregnancy morbidity rate.