Clinical Treatment Outcomes Of 45 Cases With Cesarean Scar Pregnancy

Objective:Investigate the different type of clinical characteristics and therapy results of cesarean scar pregnancy, and further provide its theoretically clinical treatment.Methods:Clinical data of 45 patients with CSP(internal-growth type of 24 cases and external-growth type of 21 cases) at the Shanxi Da Yi Hospital(2012.06-2015.12)was analyzed. According to the different treatment methods( ① drug pretreatment+curettage under ultrosound guidance, ② UACE+curettage under ultrosound guidance) different endogenous and exogenous CSP respectively divided into group A, B and C, D group.Comprehensive evaluation the value of each group’s therapeutic effect, blood loss during operation, hospitalization time and expenses, serum β-HCG values decreased to normal and thus different clinical CSP could choose reasonable treatment method. Statistic analysis was performed with SPSS 17.0.Results:1. Endogenous type A, B groups, exogenous type C, D groups: there is no statistical difference in patients’ age, gestational age, times of cesarean delivery, the time from the last cesarean delivery, the serum β-HCG on admission, gestational sac size and other aspects of contrasting groups(P>0.05).2. A.B groups: The treatment success rate, hospitalization time is not obvious compared with the two groups(P>0.05). There are statistical differences in blood loss, thenormal time needed for β-HCG down to normal and the hospitalization cost(P<0.05). The result of treating is obvious. The β-HCG returned to normal time and the hospitalization expense of group A are much shorter and lower than the other group. It is still within the acceptable range though blood loss is more in the operation, you need only a small number of blood transfusion.3. C.D groups: No statistical difference was observed in hospitalization stay. The treatment success rate, blood loss, the time of β-HCG returned to normal and hospitalization cost differences are significant in both groups(P>0.05). The result of treating is obvious and the better of group D, but the hospitalization expense of group D is higher.4. All of the 45 cases were cured and successfully retain reproductive function.Conclusions:1. The clinical symptoms of CSP are not typical, so the misdiagnosis rate is extremely high. Transvaginal ultrasound is the main diagnosis method of CSP and can could define clinical type which important for clinical procedures chosen.2. Drug pretreatment +curettage under ultrosound guidance is applicable to the endogenous type CSP. The treatment is not only has simple operation method and low cost,but also can be used in primary hospital.3. UACE+curettage guided by ultrasound technique is applicable to barren requirements and the fair economic conditions, especially for exogenous type CSP. When postoperative patients with massive hemorrhage, abdominal scar resection of the lesions are safer and more effective.