Clinical Analysis Of Treatment For Different Types Of Cesarean Scar Pregnancy

Objective:To explore the clinical effects of different treatment on different types of cesarean scar pregnancy(CSP).Methods:A retrospective analysis was made on 236 cases of CSP diagnosed in early pregnancy from January 2016 to January 2019.They were divided into type I group(95cases),type ? group(113cases)and type ? group(28cases).Compare the initial treatment effectiveness of each group.Subgroups were compared according to the treatment methods.The intraoperative bleeding volume,blood ?-HCG negative conversion time,duration of vaginal bleeding after treatment,uterine scar mass disappearance time and menstrual recovery time were compared.Results:1.The initial treatment effectiveness of group ? and group ? was significantly higher than that of group ?.Subgroup analysis showed that the initial treatment effectiveness of medication was the lowest(60.0%)in group ?,and the initial treatment effectiveness of uterine artery embolism plus uterine curettage under ultrasonography was the highest(93.1%)in group ?.2.In group ? and group ? treated with simple uterine curettage under ultrasonography or medication plus uterine curettage under ultrasonography,type I groupof the intraoperative bleeding volume,blood ?-HCG negative conversion time,duration of vaginal bleeding after treatment,uterine scar mass disappearance time were significantly better than those of type ? group(P < 0.05),but there was no significant difference in menstrual recovery time between the two groups(P > 0.05).3.Comparing the type ? and type ? groups treated with uterine artery embolization plus uterine curettage under ultrasonography,type ? group of the intraoperative bleeding volume,blood ?-HCG negative conversion time,duration of vaginal bleeding after treatment,uterine scar mass disappearance time were significantly better than those of type ? group(P < 0.05).There also was no significant difference in menstrual recovery time between the two groups(P > 0.05).Conclusion:The treatment of CSP in early pregnancy should be combined with clinical classification.Curettage under ultrasonography can be the preferred treatment for type I and some type ? CSP patients.When using the curettage under ultrasonography to be treated,type ? and type ? CSP patients with high risk of vaginal bleeding need combined medication or uterine artery embolization to effectively reduce the risk of bleeding and improve the cure rate.