Clinical Study Of Uterine Scar Pregnancy Treatment Scheme Selection

Objective: As for CSP treatment, there are many methods reportedat home and abroad and in clinical application. However, owing to the lackof strong medical evidence, there exists no standard and accuratetreatment scheme at present. Considering the CSP’s high risk ofhemorrhage, metrorrhexis, bladder injury and placenta implantation, a safeand appropriate individualized treatment scheme should be madeaccording to the characteristics of each patient. This paper is mainly aclinical study of different treatment scheme selection of Cesarean scarpregnancy after cesarean section。Methods: Retrospective analysis of106cases of uterine scarpregnancy patients that were collected and treated by the second hospitalof Jilin University from February2012to April2014. Individualizedtreatment method is selected for different patient. According to the differenttreatment methods, these patients are divided into4groups, group A: drugpretreatment+hysteroscopy treatment group,47cases; group B: bilateraluterine artery chemoembolization group,32cases; group C: abdominalsurgery,16cases; group D: Yin type uterine scar pregnancy Fetish resection group,11cases. Finally is the analysis of each group’stherapeutic effect, condition during operation, hospitalization time, cost ofhospitalization。Results: As indicated in Chart2, comparing the operative bleedingvolume, operative time, hospitalization time and the cost of hospitalizationof the four groups, group A: drug pretreatment+hysteroscopy treatment isthe least; However, group B: bilateral uterine artery chemoembolization isthe most as to the cost of hospitalization; group C: abdominal surgery usesthe most in the operative bleeding volume, operative time andhospitalization time. There is a great contrast between every two data ofthe operative bleeding volum, operative time, hospitalization time and thecost of hospitalization among the four groups; thus this is statisticallysignificant (P<0.05). While the other comparisons has no significant instatistical study(P>0.05).Conclusion: All of the four methods have high cure rate. Bycomparing the advantages and disadvantages of the four treatmentscheme, we can arrive at a conclusion: hysteroscopy is a mini-invasivemethod to cure the CSP which worth spreading. It has so manyadvantages: remove the focus completely, recover quickly, cost less,hospitalized shorter, preserve fertility, and bleed less, and so on. UAE hasmany postoperative complications and also has a high demand to the hospital’s equipment and the techniques of the operative doctors; thus thisis not the first choice of CSP treatment scheme and is hard to popularize.Meanwhile, abdominal surgery is not used as a conventional treatmentapplication. Vaginal surgery has a small operative field and a high demandto the doctors, and is easy to damage the surrounding tissue. On thisaccount, the safety and efficiency of vaginal surgery remains to beconfirmed.