Clinical Study On Different Treatment For Cesarean Scar Pregnancy Of Type Ⅰ,Ⅱ

Objective: To compare the clinical efficacy and long-term outcomes of hysteroscopic surgery,focused ultrasound ablation(FUA)combined with hysteroscopic surgery,uterine artery embolization(UAE)combined with suction curettage in the treatment of cesarean scar pregnancy of type Ⅰ,Ⅱ.Materials and Methods: The clinical data and long-term outcomes of 90 patients diagnosed as type Ⅰ and type Ⅱ CSP in Suining Central Hospital from June 2016 to May2020 were retrospectively analyzed.Results: Among the 90 cases,32 cases received hysteroscopic surgery alone,42 cases received FUA combined with hysteroscopic surgery,and 16 cases received UAE combined with suction curettage.The bleeding during the procedure of surgery in the three groups was 72.50±52.49 ml,34.64±28.93 ml,and 56.56±46.03 ml respectively.A significant difference was observed among the three groups(P=0.001).The rates with no significant changes in post-operative menstruation in the three groups were 43.8%,81.0%,and 31.3%respectively.A significant difference was observed among the three groups(P<0.001).The NRS pain score in the patients treated with FUA treatment was significantly lower than that of patients treated with UAE(P<0.001).No major complication was observed in any patient in this study.Conclusions: Either hysteroscopic surgery,FUA combined with hysteroscopic surgery,and UAE combined with curettage can be safely and effectively used in the treatment of type Ⅰ and type Ⅱ CSP.However,it seems that FUA combined with hysteroscopic surgery had less bleeding and pain and better long-term menstrual recovery.