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Comparison Of Three Different Treatment Methods For Cesarean Scar Pregnancy

Authors Fei H, Jiang X, Li T, Pan Y, Guo H, Xu X, Shu S

Received 26 June 2019

Accepted for publication 1 October 2019

Published 27 November 2019 Volume 2019:15 Pages 1377—1381

DOI https://doi.org/10.2147/TCRM.S220852

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang


Hui Fei,1,* Xuefeng Jiang,2,* Tian Li,1 Ying Pan,2 Hongling Guo,1 Xiaoyu Xu,1 Shanrong Shu2

1Department of Gynecology and Obstetrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, People’s Republic of China; 2Department of Gynecology and Obstetrics, The First Affiliated Hospital of JiNan University, Guangzhou 510630, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Shanrong Shu
Department of Gynecology and Obstetrics, The First Affiliated Hospital of JiNan University, 613 Huangpu Road West, Guangzhou 510630, People’s Republic of China
Tel +86-20-38688769
Fax +86-20-38688769
Email butterfly1705@126.com

Background/Aim: Cesarean scar pregnancy is a long term complication of cesarean section. There is a lot of controversy about the best treatment methods. We retrospectively summarized the clinical characteristics of patients with cesarean scar pregnancy and explored the advantages and disadvantages of fertility-preservation treatment method.
Methods: From January 2008 to September 2017, a total of 204 cases of cesarean scar pregnancy were retrospectively reviewed. 145 patients underwent transvaginal clearance, 33 patients underwent endoscopic surgery, and 26 patients underwent uterine artery embolism. The clinical characteristics, diagnosis, various treatment methods, and clinical outcomes were analyzed.
Results: There were no significant differences among the three groups in terms of patient age, number of previous cesarean sections, serum human chorionic gonadotropin, and clinical symptoms. The difference in mean gestational sac diameter (23.5±2.1mm vs 31.3±2.4mm vs 30.8± 1.9mm), surgical time (31.4±2.5min vs. 45.8±2.2min vs. 51.4±1.9min), blood loss (53.3± 5.5mL vs. 105.2±3.2mL vs. 75.6 ±3.5mL), blood transfusion (1/145 case vs.3/33 case vs. 0/26 case), discomfort (1/145 case vs.9/33 case vs. 16/26 case), hospital stay (6.1±1.1 day vs. 7.4±0.9 day vs.18.6±1.5 day), fever duration (1.0±0.5 day vs. 2.1±2.8 day vs. 5.7±3.5 day), and hospital expense (¥ 7825.9±234.9 vs. ¥ 10248.3± 312.9 vs. ¥ 18774.9±243.6) in transvaginal pregnancy tissue clearance, endoscopic surgery, and uterine artery embolism groups were significantly different.
Conclusion: Transvaginal clearance is an effective and relatively safe treatment option for patients with cesarean scar pregnancy.

Keywords: cesarean scar pregnancy, transvaginal clearance, endoscopy, uterine artery embolism


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