Clinical Analysis Of Uterine Artery Chemoembolization Combined With Ultrasound-guided Dilation And Curettage For Cesarean Scar Pregnancy

Objective: To investigate the clinical efficacy,safety of uterine arterial chemoembolization combined with ultrasound-guided dilation and curettage for cesarean scar pregnancy.Methods: Clinical data of 40 patients admitted and diagnosed as CSP in our hospital between September,2016 and December,2017 was studied retrospectively.In accordance with the different therapies,the cases were separated into two groups: 21 cases were accepted D&C under ultrasound within 72 h after UACE(called UACE group),19 cases were given intramuscular injection methotrexate before D&C(called MTX group).The clinical data and follow-up data between the two groups were compared and analyzed to draw the conclusion.Results: The blood loss,hospital time,time for serum ?-h CG and menstruation to normal,time of CSP mass disappearance in UACE group's and MTX group's median were respectively 50 ml and 140 ml,8days and 20 days,20days and 37 days,30days and 54 days,(14.81±3.71)days and(36.89±9.53)days.These differences were significant between the groups(P<0.01).The indexes of UACE group were less than MTX group.The median of hospital costs were respectively 12 thousand yuan and 6.85 thousand yuan,which was statistical differences(P<0.01).The UACE group's costs were expensive than MTX group.The effective rate and incidence of pain complication were compared between groups,which had significantly difference(P<0.01),and the UACE group were higher than the MTX group.With 3 cases cured after urgently uterine arterial embolization due to major bleeding at D&C,all cases in the UACE group were successfully cured.Conclusions: UACE combined with ultrasound-guided D&C for CSP was safe and feasible.It can reduce intraoperative bleeding and the risk of medical,shorten hospital stays,accelerate the serum ?-h CG and menstruation to recover.