Effect of BUAE combined with hysteroscopic electroresection on ovarian function and endometrial receptivity in patients with cesarean scar pregnancy
AN Li
WANG Lili
ZHANG Haiyan
GUO Liwen
ZHAI Mei
Abstract：Objective To investigate the effect of bilateral uterine artery embolization(BUAE)combined with hysteroscopic electrotomy on ovarian function and endometrial receptivity in patients with cesarean scar pregnancy(CSP).Methods The clinical data of 124 patients with CSP who underwent hysteroscopic electrotomy from January to June 2022 were retrospectively analyzed.According to presence or absence of combined BUAE,they were divided into the observation group(n=64)and the control group(n=60).Both groups received hysteroscopic electrotomy.The control group received intramuscular injection of Methotrexate,and the observation group was given injection of Methotrexate via bilateral uterine artery combined with BUAE.All patients were followed up for 2 years.The operation conditions(intraoperative blood loss,duration of operation,vaginal bleeding time,menstrual recovery time),ovarian function[follicle stimulating hormone(FSH),luteinizing hormone(LH),FSH/LH,inhibin B(INHB)]before operation and on the second day of the third menstrual cycle after operation,as well as the endometrial receptivity[endometrial thickness(ET),endometrial volume(EV),blood flow index(FI)]before and at 3 months after operation,were compared between the two groups.The incidence of postoperative complications and subsequent pregnancy status(subsequent pregnancy rate,rate of recurrent CSP,and rate of placental abnormalities during pregnancy)were recorded.Results The intraoperative blood loss,duration of operation,vaginal bleeding time and menstruation recovery time in the observation group were lower or shorter than those in the control group(P<0.01).On the second day of the third menstrual cycle after operation,the levels of FSH and LH were significantly higher than those before operation(P<0.05),but there were no significant differences in the levels of FSH/LH and INHB between the two groups(P>0.05),nor in the levels of FSH,LH,FSH/LH and INHB between the two groups(P>0.05).At 3 months after operation,the ED,EV,and FI of the two groups were lower than those before operation(P<0.05),and there was no significant difference in ED,EV,and FI between the two groups(P>0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).There were no significant differences in subsequent pregnancy rate,rate of recurrent CSP,and rate of placental abnormalities during pregnancy in the observation group(P>0.05).Conclusion BUAE combined with hysteroscopic electrotomy in the treatment of CSP is beneficial to reducing intraoperative bleeding,shortening the duration of operation and postoperative recovery time,does not affect the ovarian function and endometrial receptivity of patients,and can reduce postoperative complications,without affecting subsequent pregnancy.
Keywords：cesarean scar pregnancybilateral uterine artery embolizationhysteroscopic electrotomyfollicle stimulating hormoneluteinizing hormoneendometrial receptivitysubsequent pregnancy
Publication Date：2025-09-28
Online Publishing Date：2025-10-17(First online date of this platform, not the publication date of the document)
Pages：5( 49-53 )