Identifying Risk Factors For Recurrence Of Caesarean Section Scar Pregnancy

Objective:To explore the related factors that may lead to the recurrence of cesarean scar pregnancy?CSP?after treatment,so as to provide basis for the prevention and prediction of CSP recurrence.Methods:The clinical data of CSP patients who were diagnosed and operated in our hospital from July 2014 to July 2018 were collected,and their postoperative fertility was further followed up.According to whether CSP occurred again,they were divided into two groups:group A?the result of re pregnancy was normal intrauterine pregnancy group?and group B?the result of re pregnancy was still CSP group?.The clinical data of the two groups at the onset of the first CSP were compared by single factor analysis Materials,the variables with significant statistical significance?P<0.05?were further analyzed by multivariate logistic regression,and the relevant factors influencing the recurrence of CSP were obtained.Results:Univariate analysis showed that there were statistically significant differences in hospital level,clinical classification,age,hematocrit,delivery times,recovery time from operation to menstruation and 24-hour decrease rate of hCG?P<0.05?.The above variables were included in the multivariate logistic analysis.The results showed that the previous CS hospital level?P=0.035,OR=0.454,OR 95%C.I[0.218,0.947]?,postoperative hematocrit?P=0.020,OR=0.794,OR 95%C.I[0.654,0.965]?were the protective factors for recurrence of CSP.The clinical classification of CSP?P=0.002,OR=11.433,OR 95%C.I[2.475?,52.803]),age?P=0.007,OR=1.344,OR 95%C.I[1.083,1.667]?were risk factors for recurrence CSP.The prediction formula of recurrence probability after treatment of CSP is:P=1/[1+exp?-65.717-0.789x₁+2.436x₂+0.295x₃-0.230x₄?].Draw the receiver operating characteristic curve?ROC?,the area under the curve?AUC?is equal to 0.935,and its 95%confidence interval is[0.889,0.980],indicating the high prediction efficiency of the regression model.Conclusion:the occurrence of CSP can be fundamentally prevented by the strictly master the indications of cesarean section and the improvement of the quality of cesarean section.The risk of CSP in the second pregnancy after CSP treatment should be informed to the patients and closely monitored and followed up after pregnancy.Long-term and safe contraceptive measures should be implemented for CSP patients who have no need of childbearing after treatment.