Clinical Application Of Interventional Embolization In Termination Of Pregnancy In Scar Pregnancy And Placenta Previa Stage

ObjectiveTo analyze the clinical application value of interventional embolization in the termination of pregnancy in scar pregnancy and placenta previa state.MethodsFrom Jan.2014 to Jan.2019,a series of patients in Qianfoshan Hospital of Shandong Province were retrospectively analyzed,who with abnormal placental implantation in early and middle pregnancy stage have been terminated pregnancy.The scar pregnancy were selected for the study of abnormal placental implantation in the early stage.The placenta previa state were selected for the study of abnormal placental implantation in the middle stage.A total of 192 cases were collected.Of them,176 patients were followed up successfully.According to the diagnosis of disease,they were divided into A and B groups:Group A: 131 patients with scar pregnancy were divided into observation group(45 cases)and control group(86 cases)on the basis of different treatment options.Observation Group:Interventional embolization+ MTX+ Curettage.Control Group: MTX+Curettage.Group B:45 patients with placenta previa state were divided into observation group(18 cases)and control group(27 cases)on the basis of different induced labor options.Observation Group:Interventional embolization+ Ethacridine lactate(Rivano).Control Group: Ethacridine lactate.The embolized arteries of interventional embolization were bilateral uterine arteries.Searching the patients’ case data in the medical record bank to retrospectively analyze the general condition of patients and the process of diagnosis and the outcome of treatment.Follow up complications and repregnancy status,compare and analyze the clinical effect and application value of different treatment schemes.ResultsGroup A: The two groups’ general information in age,menopause days,number of pregnancies,abortions,caesarean section,time from the last caesarean section and gestational sac size had no significant difference(P>0.05).Pregnancy tissue clearance rate,success rate of terminate pregnancy,bleeding volume,blood transfusion rate,curettage time,incidence of general complications,one-week decline rate of HCG,menstrual recovery time and hospitalization time in the observation group were significantly less than those in the control group(P<0.05).In the observation group,6 patients had complications related to interventional embolization and all recovered after symptomatic treatment.The proportion of first menstrual return to normal and the pregnancy rate between the two groups had no significant difference(P>0.05).The hospitalization cost of the observation group was significantly different from that of the control group(P<0.05).Group B: Age,gestational age and number of pregnancies,deliveries,abortions between the two groups had no significant difference(P>0.05).The time of induced labor,onetime clearance rate of pregnancy tissue,successful rate of induced labor,amount of bleeding,transfusion rate,incidence of general complications,time of menstrual recovery and length of hospital stay in the observation group were significantly less than those in the control group(P<0.05).One patient in the observation group had complications related to interventional embolization and recovered after symptomatic treatment.The proportion of first menstruation returning to normal and the pregnancy rate between the two groups had no significant difference(P>0.05).The hospitalization expenses of the observation group were significantly different from those of the control group(P<0.05).Conclusions1.Uterine artery embolization can effectively prevent bleeding and hemostasis,promote the decline of pregnant tissues,accelerate the progress of treatment and reduce the activity of trophoblasts.It has the advantages of simple operation,definite curative effect,high safety,quick recovery and fewer complications,etc.2.Uterine artery embolization does not have irreversible effects on genital system and fertility.3.The cost of uterine artery embolization combined with drugs or surgical is higher than that of traditional treatment.The large sample data and evidence-based medical are not yet complete.The long-term effect and application standard need further evaluation.In order to reduce the incidence of risk,patients should be informed of the relevant situation and risk before operation,and regular follow-up after operation.