Comparison of Three Therapeutic Methods for Cesarean Scar Pregnancy After Cesarean Section

WU Pengying

doi:10.3969/j.issn.1672-7185.2019.11.021

Abstract：Objective? To compare three methods in treating cesarean scar pregnancy after cesarean section. Methods A total of 50 cases of cesarean scar pregnancy after cesarean section in Tai’an Enliang Hospital from January 2017 to December 2018 were selected for clinical study. They were divided into three groups according to their personal wishes and whether they met the relevant treatment indications. In the embolization group, 18 cases were treated by uterine artery embolization combined with uterine curettage under the guidance of B-ultrasound. In the repair group, pregnancy clearance and uterine scar repair were guided in 16 cases. The 16 cases in drug group underwent uterine curettage after oral methotrexate combined with mifepristone killing embryos. Comparing the effects of three treatments. Results The amount of bleeding during operation, the time of vaginal bleeding after operation, the time of using antibiotics and the time of hospitalization were significantly different(P<0.05). The amount of bleeding during operation, the time of vaginal bleeding after operation, the time of using antibiotics and the time of hospitalization in the embolization group were less than those in the repair group and the drug group, while the operation time in the drug group was the shortest. No serious complications occurred in all three groups, and menstruation returned to normal within 2 months after operation. Conclusion For the treatment of cesarean scar pregnancy after cesarean section, uterine artery embolization combined with B-ultrasound-guided uterine curettage is minimally invasive and safe, but those who need pregnancy are cautious to choose. Vaginal pregnancy clearance and uterine scar repair are radical, but the risk of operation is high. After drug killing embryos, uterine curettage under B-ultrasound-guided is minimally invasive and safe, but the patient stayed in hospital for a long time. For the treatment of cesarean scar pregnancy after cesarean section, individualized treatment should be formulated according to the patient’s condition and different fertility needs.