Analysis Of Clinical Data Of Cervical Pregnancy

Objective:To evaluate the safest,suitable and effective treatment method for cervical pregnancy.Methods:We retrospectively analyzed the clinical data of 98 patients with cervical pregnancy admitted to our hospital from November 2002 to December 2017.They were divided into3 groups according to different treatment methods: the curettage group(N=34),drug+curettage group(N=19),and uterine artery embolization + curettage group(N=45).The relationship between gestational sac size,human chorionic gonadotropin(HCG),pulsatility without cardiac tube,blood flow signal around the gestational sac,the methods of treatment and outcome were analyzed.Results:The success rates of treatment were 52.9%(N=18),71.4%(N=15)and 100%(N=58)among the curettage group,drug + curettage group and uterine artery embolization +curettage group,respectively.All patients successfully retained the uterus.Gynecologists performed curettage under the condition of blood preparation for patients with the signals of blood flow around the gestational sac are not abundant,the gestational sac < 3cm and HCG ≤ 7000mIU/ml.While for patients with abundant signals of blood flow,the gestational sac < 3cm,7000mIU/ml < HCG < 15000mIU/ml,they gave mifepristone+misoprostol or mifepristone + methotrexate before curettage.After the curettage,mifepristone was given if the level of HCG is unsatisfactory or if the curettage is incomplete.Uterine artery embolization and curettage should be performed for prevention in patients with gestational sac > 3cm,HCG > 15000mIU/ml and blood flow around the gestational sac was abundant.Conclusion:The risk of bleeding in patients with cervical pregnancy is high.Early diagnosis is especially important for the treatment of cervical pregnancy.The success rate of drug treatment is low,and the risk of massive bleeding is undesirable.The curettage,drug+curettage can try if the patients is safety.Uterine artery embolization plus curettage is a relatively safe and thorough treatment.In patients with massive bleeding caused by other ways,it could successfully stopped bleeding and retained the uterus of these patients,relieving the pain and improving their quality of life.