Laparoscopic Uterine Arteries Ligation Combined with Uterine Curettage in Treatment of Cesarean Scar ;Pregnancy

CUI Na; DUAN Zhi-min; ZHU Ji-hong; LI Ya; LI Miao

Abstract：Objective: To discuss the treatment of cesarean scar pregnancy (CSP) by the laparoscopic uterine arteries ligation combined with uterine curetlage. Methods:Sixty cases with CSP were retrospectively analyzed from January 2011 to January 2014 in our hospital. The cases were divided into two groups depending on different treatments: patients in the interventional therapy group (n=30)accepted bilateral uterine artery embolization,patients in the laparoscopic operation group (n=30)were treated by laparoscopy. When the uterine arteries were blocked by interventional or laparoscopic method,the uterine curettage under ultrasonic guidance was completed. The curative effects were compared, including the length of time of hCG descending to normal ,the intraoperative bleeding volume and the postoperative adverse reaction. Results:There were not significant differences in the operative time and the postoperative period of menses return between two groups (P>0.05). The blood loss,the time of hCG restored to normal range and the total hospital costs in the laparoscopic operation group were significantly lower than those in the interventional therapy group (P<0.05). The incidences of abdominal pain,fever and leukocytosis in the laparoscopic operation group were also significantly lower (P<0.05). However, there were not significant differences in the incidences of nausea, vomiting and other gastrointestinal reactions between the two groups (P>0.05). Conclusions:The laparoscopic uterine arteries ligation combined with uterine curettage is one of good treatments of CSP with its safety and efficiency.