Study Of Two Therapeutic Methods In Cesarean Scar Pregnancy

Objective：Explore the clinical manifestations effect of patients with cesarean scarpregnancy. To compare the availability between curettage of uterus after uterine arteryembolization and methotrexate pharmacotherapy in cesarean scar pregnancy. To provide asafe, effective and feasible treatment plan for patients with cesarean scar pregnancy.Methods： Retrospectively study forty-six cases of cesarean scar pregnancy patients thattreated in our hospital from2010to2013. They respectively accepted drugs treatment andinterventional therapy. Drugs group: MTX muscle injection and mifepristone influencesoral+curettage of uterus,23cases in group; interventional group: uterine artery embolizationand artery perfusion MTX+curettage of uterus. To retrospectively analyze the clinical date ofeach of the above groups, such as the clinical manifestation, blood volume, the descent ofβ-hCG hospital day, menstruation onset, and side reaction.Results：1. There were32cases in the46patients emerging vaginal irregular bleedingsymptom;4cases abdominal pain or discomfort;6cases vaginal irregular bleeding withabdominal pain;4cases having no clinical symptoms.The rates were69.6%，8.7%，13.0%，8.7%.2. Before treatment the general information of two groups of patients: age,menopause for a few days, sac size, cut the muscle thickness and initial serum β-HCG, thedifference was not statistically significant (P>0.05).3. MTX muscle injection+mifepristone influences oral+curettage of uterus and uterine artery embolization+arteryperfusion MTX+curettage of uterus can acquire a good therapeutic effect, if we makeappropriate use of them. There is significant difference among the two groups in bloodvolume, the descent of β-HCG, the time from the treatment to curettage, menstruation onset, the difference hadstatistical significance (P＜0.05);4. Intervention group in postoperative1d21cases(91.3%) blood β-HCG decline, dropping from1.5to20.9%.Conclusion：1. Cesarean scar pregnancy have nonspecific clinical characteristics,Clinicians should deepen our understanding of the disease, for pregnant women with previouscesarean section we should be vigilant to avoid misdiagnosis;2. With transvaginalultrasound, hysteroscopy popularity, we should try to make an early diagnosis of thedisease,due to the current lack of a large variety of therapeutic statistical analysis, so thetreatment according to the patient’s condition and doctors’ experience, if we make appropriateuse of them, it is good;3. MTX muscle injection and mifepristone influences oral+curettageof uterus and uterine artery embolization and artery perfusion MTX+curettage of uterus canacquire a good therapeutic effect;4. Uterine artery embolization and artery perfusion MTX+curettage of uterus is a safe and efficient method for the uterine scar pregnancy.