Hysteroscopic Uterine Artery Embolization in Cesarean Scar Pregnancy Combined with Uterine Arteriovenous Fistula and Its Safety Analysis
YAO Manhong
LIU Yufeng
AI Zhigang
YANG Xiaojie
YAO Manling
WANG Ying
Abstract：Objective To investigate the efficacy and safety of hysteroscopic uterine artery embolization(H-UAE)in patients with cesarean scar pregnancy(CSP)combined with uterine arteriovenous fistula(UAVF).Methods Eighty patients diagnosed with CSP-UAVF who were admitted to Tangshan Maternal and Child Health Hospital from January 2020 to Decem-ber 2024 were enrolled and divided into the H-UAE group(40 cases)and the control group(40 cases)using the random number table method.Patients in the H-UAE group underwent H-UAE surgery,while those in the control group underwent the direct hysteroscopic surgery.The success rate of surgery,intraoperative bleeding(volume),menstrual recovery time,time to normal-ization of human chorionic gonadotropin(HCG)levels,length of hospitalization,and incidence of adverse reactions were com-pared between the two groups.The quality of life and treatment satisfaction of patients were assessed using the Comprehensive Quality of Life Assessment Questionnaire(GQOLI-74)and a hospital satisfaction questionnaire,respectively.Results In the H-UAE group,the following outcomes were significantly better than those in the control group:surgical success rate(95.00％vs 72.50％),intraoperative bleeding(volume)(35.48±7.51 mL vs 132.07±10.69 mL),time to recovery of menstruation(23.73±8.91 days vs 39.85±8.02 days),time to normalization of HCG levels(18.50±4.82 days vs 31.48±7.43 days),length of hospitalization(9.65±3.28 days vs 16.10±3.24 days),incidence of adverse reactions(10.00％ vs 27.50％),somatic function(79.30±5.06 points vs 72.03±5.31 points),psychological function(82.45±5.38 points vs 72.22±3.80 points),social function(79.22±5.11 points vs 71.10±5.32 points),material life(74.15±4.83 points vs 64.43±5.00 points),and treatment satisfaction(95.00％ vs 80.00％)(P＜0.05).Conclusion H-UAE combined with hemostasis and precision clearance for the treatment of CSP-UAVF is highly effective,less invasive,associated with faster recovery,improved safety,and significantly enhances pa-tients' quality of life and treatment satisfaction.
Keywords：Cesarean scar pregnancyUterine arteriovenous fistulaUterine artery embolizationHysteroscopic operation
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 27-31 )