Comparison of Five Treatment Strategies for Cesarean Scar Pregnancy  

作　　者：Feng-Yi Xiao Xiao-Hong Xue Xin Lu 

机构地区：[1]Department of Gynaecology,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200032,China

出　　处：《Reproductive and Developmental Medicine》2018年第2期88-94,共7页生殖与发育医学（英文版）

摘　　要：Objective:To explore appropriate treatment strategy for cesarean scar pregnancy(CSP)in the first and second trimester.Methods:Clinical characteristics and treatment strategies in 182 patients with CSP were retrospectively analyzed.Treatment strategies were as follows:Group A(n=102),uterine artery chemoembolization(UACE)followed by dilation and curettage(D&C);Group B(n=63),D&C;Group C(n=6),hysteroscopy;Group D(n=6),laparotomy;and Group E(n=5),laparoscopy.The basic clinical findings were collected and analyzed,along with the curative effects.Results:The preoperative serum beta-human chorionic gonadotropin(β-HCG)level was in the order of Group D,A>B,C>E(P=0.001);the size of gestational sac(GS)was in the order of Group D,E>A,C>B(P=0.000);and the thickness of the anterior myometrium was in the order of Group B>A,C>D,E(P=0.000).Three cases in the second trimester were all in Group D;two cases were treated with UACE before laparotomy with moderate blood loss(100 and 200 mL,respectively)and the third case was initially treated with D&C and had severe hemorrhage.Conclusions:The diameter of GS,thickness of the anterior myometrium,and preoperativeβ-HCG level are important factors for the choice of treatment.UACE combined with D&C is a useful measure for most Type 2 CSP cases in the first trimester.For Type 2 CSP cases in the second trimester,UACE before laparotomy could be a reasonable choice.

关 键 词：Cesarean Scar Pregnancy HYSTEROSCOPY LAPAROSCOPY LAPAROTOMY Uterine Artery Chemoembolization 

分 类 号：R714.22[医药卫生—妇产科学]