A multicenter study on focused ultrasound ablation surgery for cesarean scar pregnancy
ZHU Xiao-gang
XIONG Li
HE Chang-hui
YU Hong-fan
PENG Li-xiu
CHENG Wei
XUE Min
Abstract：Objective To investigate the clinical efficacy of focused ultrasound ablation surgery(FUAS)for different types of cesarean scar pregnancy(CSP)and the factors affecting bleeding volume and readmission.Methods From January 2014 to December 2023,1581 patients with cesarean scar pregnancy were treated by FUAS in the 3rd Xiangya Hospital of Central South University,Hunan Maternal and Child Health Care Hospital,and Chenzhou First People's Hospital,and their data were retrospectively analyzed.The efficacy and safety of FUAS for different types of CSP,and the influencing factors of bleeding volume and readmission were analyzed.Results All the patients completed FUAS successfully in one session.After FUAS,color Doppler ultrasound showed a significant decrease in blood flow signal,while contrast-enhanced ultrasound showed no enhancement in the treated area.The median volume of blood loss in curettage was 20mL(range:5-950mL).The amount of bleeding volume more than 200mL was observed in 62 patients(4.4％,62/1425),and 64 patients(4.0％,64/1581)were readmitted after curettage.The blood supply of the mass(P=0.006)and the largest diameter of the mass(P=0.03)were the risk factors affecting the amount of bleeding during curettage.The lesions with blood supply of grades 3-4 and the size larger than 30.5mm were more likely to lead to major bleeding.The risk of readmission was related to the type of CSP(P=0.01),and the risk of readmission of patients was increased by 3rd type of CSP.No serious complications such as intestinal and nerve injury occurred during FUAS.Conclusions FUAS combined with curettage is safe and effective in the treatment of different types of CSP.The blood supply of grades 3-4 and the largest diameter more than 30.5mm of the lesion are more likely to result in bleeding,and the patients with 3rd type CSP have a higher risk of readmission.
Keywords：cesarean scar pregnancyfocused ultrasound ablation surgeryeffectivenesssafetyinfluencing factors
Publication Date：2024-09-02
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 932-936 )