A Retrospective Analysis Of Clinical Data And Discussion In Feasibility Of Directly Surgical Treatment In 33 Cases Of Early-term Cervical Pregnancy

Background and ObjectiveCervical pregnancy is one of the rarest ectopic pregnancies,which accounts for<1%of ectopic pregnancies.However,its incidence tends to increase due to increased number of application of assisted reproductive technology in recent years.It is also considered to be the extremely dangerous clinically because of life-threatening hemorrhage,possibility of hysterectomy.Nevertheless,due to its rarity,no consensus regarding the best therapeutic approach for cervical pregnancy and lack of clinical experiences,its of great significance in early diagnosis,correct assessment of patient's condition and rational approach of patient care.With the improvement of living standards,awareness of health care of people and early diagnosis in cervical pregnancy benefited from development of medical technology,there is no unified treatment guideline,though.In order to investigate a safe and effective mode of treatment with the advantage of affordable at the same time,33 cases of cervical pregnancy admitted in Qilu Hospital from May 2012 to July 2019 were retrospectively analyzed.By comparing the clinical effect of medical treatment or uterine artery embolism combined with surgical treatment with directly surgical treatment,so as to select a more appropriate method of treatment for the first trimester(gestational age?12 weeks)of cervical pregnancy.Method33 cases of cervical pregnancy with complete clinical data from May 2012 to July 2019 admitted in Qilu Hospital were retrospectively analyzed by us.they were divided into two groups according to different treatment methods,group A and group B.Group A(13 cases):medical treatment or uterine artery embolism combined with surgical treatment,and group B(20cases):surgical treatment.The hospitalization time,hospitalization expense,bleeding volume during surgery,variation of hCG,the method of treatment and outcome were analyzed.ResultAll patients were treated successfully with no serious adverse effect and complication.They all prevent from hysterectomy.Two patients in group A and one patient in group B accepted blood transfusion.The differences of hospitalization time and expense between group A and group B was significant statistically,that is,the hospitalization time and expense of group A were less than group B apparently(t=4.56,P=0.001),(t=3.451,P=0.004);there was significant difference in variation of hCG between group A and group B statistically,however,the variation of hCG in group A was bigger than it in group B(t=3.81,P=0.001).However,there were no statistically significant differences between group A and group B in the bleeding volume during surgery,the time of hCG normalization and recovery in menstruation(P?0.05).The time of 25 patients follow-up recovered their menstruation was between 30 to 85 days after their discharged.ConclusionThe benefit of therapeutic effect in the assisted treatment with medical treatment/uterine artery embolism is limited for the first trimester of cervical pregnancy,while the direct surgical treatment could cut down the hospitalization time and expense significantly,with the advantage of safety and effectivity.