Choice Of Method For Cesarean Scar Pregnancy Treatment

Objective: At present,there is no uniform standard for diagnosis and treatment of cesarean scar pregnancy(CSP)at home and abroad,to explore the effectiveness of CSP treatment and the choice of treatment methodsMethods: According to the current diagnostic criteria of classical Godin CSP ultrasound and serum human chorionic gonadotropin(HCG)level as diagnosis standard of CSP.A retrospective analysis of clinical data from January 2014 to December 2016 in General Hospital Affiliated to Tianjin Medical University obstetrics and 240 cases of CSP,including I CSP165,II CSP75.125 I CSP underwent bilateral uterine artery chemoembolization + curettage(embolization group),40 cases of type I CSP hysteroscopic scar Lesion resection and curettage(hysteroscopic group),75 cases of type II CSP laparoscopic bilateral uterine artery ligation and scar resection and repair of the uterus(laparoscopic group).Observe 3 groups of patients,surgery,operative time,intraoperative blood loss,blood HCG decreased to normal level.The normal menstrual recovery time required.Results: all the 240 patients were operated successfully,no bleeding,no conversion to open surgery,no serious complications 1.embolization group operation time was 35 ~ 55 min,(43.8 + 4.1)min,the intraoperative blood loss was 5ml ~ 30ml(10.4 + 2.7)ml,blood HCG the first postoperative day decreased by more than 50%,13 ~ 25d(19.2 + 1.1)d,decreased to normal level,hospitalization time 2 ~ 4d,(3.1 + 0.4)d,34 ~ 60 d,after operation,(43.5 + 5.2)d,normal menstruation.2.hysteroscopy group operation time was 20 ~ 50 min,(33.6 + 2.4)min,the intraoperative blood loss was 10 ml ~ 30ml(17.7 + 4.1)ml,blood HCG the first postoperative day decreased by more than 50%,16 ~ 24d(18.5 + 3.3)d decreased to normal level,hospitalization time 2 ~ 4d,(2.8 + 0.5)d,38 ~ 67 d,after operation,(46.3 + 6.1)d,normal menstruation.3.The 3 group of laparoscopic operation time was 50 ~ 130 min,(60.5 + 7.8)min,the intraoperative blood loss was 30 ml ~ 400ml(60.9 + 5.6)ml,blood HCG the first postoperative day decreased by more than 50%,15 ~ 26d(18.1 + 2.3)d decreased to normal level,hospitalization time 3 ~ 7d(4.4 + 0.8)d,36 ~ 61 d,after operation,(46.6 + 3.2)d,normal menstruation.Conclusion: CSP patients should be according to the specific condition,clinical type,strict control of indications,choosing the appropriate cases,corresponding to a reasonable treatment,not only can make the disease.