| ObjectiveTo summarize the efficacy and safety of uterine artery embolization in the treatment of cesarean scar pregnancy, and to evaluate its’ clinical value, according to the clinical efficacy, complications, level of HCG decreased, length of stay, menstruation, ovarian function, re-pregnancy, etc..MethodsClinical data of 64 CSP been treated with uterine artery embolization in Yongchuan Hospital of Chongqing Medical University between January 2011 and February 2016 was retrospectively analyzed. The success rate of UAE, amount of vaginal bleeding after UAE, way of pregnancy terminated, rate of hysterectomy, postoperative adverse reactions, complications, level of HCG decreased, hospital stay were summed up.Patients’ menstrual conditions,sexual hormone level, morphology of ovary and uterus,re-pregnancy after the treatment were followed up.Results1. The success rate of uterine artery embolization was 100%,andthe effective rate of UAE to avoid massive hemorrhage is 93.75%. The proportion of uterine bleeding after UAE is as follows: 43.75% was less than 30 ml, 54.69% was less than 50 ml, 79.69% was less than 100 ml, 93.75% was less than 500 ml.2. All the patients terminated the pregnancy successfully, and 56 cases(85.94%) successfully removed the pregnancy tissues by once curettage or hysteroscopy, 1 case(1.56%) underwent open surgery, 3 cases(4.69%) underwent twice curettage, 1 case(1.56%) underwent twice hysteroscopy, 2 case(3.12%) was changed to laparotomy, 1 case(1.56%) was changed to laparoscopic surgery, 1 case(1.56%) underwent hysterectomy.3. The average decrease of blood beta-HCG in one week was(7329.96±6128.73) UI/L, and the average decline percentage was(79.64±19.39)%.Hospitalization time was 3-25 days, the average length of stay was(6.2±3.8) days.4. 3 cases(4.69%) had mild abdominal pain, 1(1.56%) had low fever, and 1(1.56%) had right gluteus ischemic pain. One(1.56%) telephone follow-up patient with a sense of right leg pain at the puncture intervention after strenuous activity, there were no pelvic infection, ischemic necrosis of adjacent organs, ectopic embolism and other serious complications or sequelae occurred.5. 5 cases were lost including the hysterectomy one.The 59 successful follow-up cases did not complaint obvious discomfort, and after 3 months all the patients’ sexual hormones returned to normal levels, gynecological ultrasound showed that all uterine shapes and sizes were in the normal range and the ovaries had no signs of atrophy. 58 cases recovered menstruation, in which 8 cases’ menstruation were reduced, 3 cases’ menstrual cycle were abnormal. 1 case did not resume menstruation. 8 cases were re-pregnant again.Conclusion1. UAE in the treatment of CSP have a high success rate, and it can prevent uterine bleeding effectively.2. UAE can reduce the risk and difficulty of the curettage or other surgical procedures, increase the success rate of once curettage, reduce the risk of uterine bleeding in the secondary curettage, and reduce the risk of hysterectomy.3. The level of HCG decrease fast and the average length of stay is short using UAE to treat CSP.4. The incidence of adverse reactions is low and symptoms are mild, the complications is rare in this therapy.5. Uterine artery embolization has no effect on menstruation recovery, it may lead to a reduction in the amount of menstruation; it has no effect on uterine and ovarian function and re-pregnancy.6. UAE in the treatment of CSP is safe, effective and of high clinical value, worthy of clinical application. |
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