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Tytuł:
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Comparing the clinical efficacy of three surgical methods for cesarean scar pregnancy.
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Autorzy:
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Zeng S; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, 510630, Guangzhou, Guangdong, China.; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Wang Y; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Ye P; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Xu L; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Han W; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Li F; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Tang C; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Zhou J; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China.
Xie X; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, 34100, Ganzhou, Jiangxi, China. .; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Gannan Medical University, No.128 Jin Ling Road, Ganzhou, Jiangxi, 34100, China. .
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Źródło:
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BMC women's health [BMC Womens Health] 2023 May 17; Vol. 23 (1), pp. 271. Date of Electronic Publication: 2023 May 17.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: [London] : BioMed Central, 2001-
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MeSH Terms:
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Pregnancy, Ectopic*/surgery
Pregnancy, Ectopic*/etiology
Uterine Artery Embolization*
Pregnancy ; Female ; Humans ; Cicatrix/etiology ; Cicatrix/surgery ; Cesarean Section/adverse effects ; Retrospective Studies ; Methotrexate/therapeutic use ; Treatment Outcome
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References:
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Contributed Indexing:
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Keywords: Cesarean section scar pregnancy; Hysteroscopy; Ultrasonic monitoring; Uterine curettage
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Substance Nomenclature:
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YL5FZ2Y5U1 (Methotrexate)
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Entry Date(s):
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Date Created: 20230517 Date Completed: 20230519 Latest Revision: 20230525
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Update Code:
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20240105
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PubMed Central ID:
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PMC10193701
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DOI:
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10.1186/s12905-023-02415-y
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PMID:
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37198658
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Background: We aimed to compare the clinical efficacy of three surgical methods in the treatment of various types of cesarean scar pregnancy (CSP).
Methods: Herein, 314 cases of CSP were treated in the department of Obstetrics and Gynecology of the First Affiliated Hospital of Gannan Medical University between June 2017 and June 2020. The patients were divided into three groups based on the treatment received: group A (n = 146; curettage by pituitrin combined with ultrasonic monitoring and hysteroscopy-guided surgery), group B [n = 90; curettage after methotrexate (MTX) injection into the local gestational sac], and group C (n = 78; laparoscopic, transvaginal, and transabdominal cesarean scar resection). These groups were divided into three subgroups (type I, type II, and type III) according to the CSP type of the patients.
Results: The intraoperative blood loss, length of hospital stay, hospitalization cost, menstrual recovery time, and serum β-HCG normalization time were lower in groups A than in groups B or C with type I, II and III CSP (P < 0.05). Operative efficiency and Successful second pregnancy rate were higher in groups A than in groups B or C with type I and II CSP (P < 0.05). But in type III CSP, the complications were more serious in group A than group C.
Conclusions: Curettage by pituitrin combined with ultrasonic monitoring and hysteroscopy-guided surgery is an effective and relatively safe treatment for patients with type I and II CSP. Laparoscopic surgery is more suitable for type III CSP.
(© 2023. The Author(s).)
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