Comparison Of The Efficacy Of Uterine Arterial Embolization In The Treatment Of Mass And Non-mass Cesarean Scar Pregnancy

OBJECTIVE:Retrospective analysis of the efficacy of uterine curettage after uterine arterial embolization for non-mass and mass-type cesarean scar pregnancy,and evaluate its safety and value in the latter(mass CSP)treatment,providing a reference for clinical diagnosis and treatment.RESEARCH METHOD:A total of 154 early CSP patients admitted to our hospital's gynecology department from January 2010 to December 2019 were selected.All patients were diagnosed by our hospital with transvaginal color Doppler ultrasound and/or MRI(first or non-first diagnosis).After admission,A total of 87 CSP patients underwent uterine curettage after uterine artery(chemotherapy)embolization.With reference to the classification method in the 2016 "Consultation of Experts in Diagnosis and Treatment of CSP",patients were re-divided into two groups,the non-mass group and the mass-type group.Complete examination after admission if there are no contraindications to interventional surgery,interventional surgery is performed first,and uterine curettage is performed within 24-72 hours.The age,number of pregnancies,number of cesarean sections,time since last cesarean section(years),preoperative HCG level,preoperative HGB,gestational week,number of menopause days,perioperative bleeding volume,HCG decline rate,and hospitalization days,postoperative hospital stay,hospitalization costs,treatment success rate,follow-up treatment and adverse reactions were compared between the two groupsRESULTS:There were no significant differences in age,number of pregnancies,number of cesarean sections,time since last cesarean section(years),and HCG levels before surgery in the two groups(P>0.05).There were statistically significant differences in menopause days[(50.64±10.691)and(62.00±15.737),respectively],gestational weeks[(6.14±1.478)and(7.65±1.730),respectively],and preoperative hemoglobin[(120.78±11.822)and(96.50±19.983),respectively]between the two groups of patients(P<0.05).There were no significant differences in blood HCG reduction rates,perioperative bleeding volume,hospitalization costs,and length of hospitalization between the two groups of patients(P>0.05).There were statistically significant differences in postoperative hospital stay[(3.67±1.868)and(5.44±3.148),respectively]between the two groups of patients(P<0.05).There was no significant difference in the treatment success rates between the two groups of patients[97.1%(67/69)and 88.9%(16/18),respectively](P>0.05).CONCLUSION:There is no recognized best treatment for CSP,but the current research shows that the classification of CSP is closely related to the choice and success of treatment.Regardless of the non-mass type or mass type CSP,uterine artery(chemotherapy)embolization has the advantages of safe,effective,less invasive,and fast postoperative recovery.It is worth recommending,especially for masses Cesarean scar pregnancy with unclear treatment options.