Clinical Data Analysis And Treatment Of Scar Pregnancy After Cesarean Section

Objective By analyzing the general clinical characteristics of patients with scar pregnancy after cesarean section,this paper summarizes the high risk factors,and compares the advantages and disadvantages of two different treatment schemes for patients with scar pregnancy after cesarean section,so as to provide reference for the treatment of patients with scar pregnancy in clinic and formulate reasonable individualized treatment.method 1.From January 2016 to December 2020,103 patients who were hospitalized for cesarean scar pregnancy in the Affiliated Hospital of Inner Mongolia Medical University and successfully treated were collected as the experimental group to understand their detailed information.2.Randomly selected 103 patients with scar uterus,full-term pregnancy and delivery in our hospital as the control group,and compared the two groups to investigate and statistically analyze the risk factors of scar pregnancy.3.According to the different treatment methods of scar pregnancy patients in our hospital,they were divided into two groups: uterine artery embolization combined with ultrasound-guided uterine curettage(uterine curettage group),uterine artery embolization combined with excision of vaginal scar pregnancy focus and scar repair(operation group).The general data,diagnosis and treatment,prognosis and other related data of the two groups were statistically analyzed.Result 1.there are significant differences between the experimental group and the control group in terms of pregnancy times,induced abortion times,cesarean section times and time before the previous cesarean section(p < 0.05),but there are no significant differences in the reasons of the previous cesarean section,the time of menstruation resurgence and the time of lactation(p > 0.05).the results of multivariate unconditional logistic regression analysis show that pregnancy times,induced abortion times,cesarean section times and time before the previous cesarean section all have influence on CSP.2.The mean maximum diameter of gestational sac in patients with type ⅢCSP was 39.5±14.279 mm,which was larger than that of typeⅠCSP(24.57±10.254 mm mm)and type ⅡCSP(28.95±9.578 mm mm),and the difference was statistically significant(P < 0.05).The mean menopause days of CSP patients were: type ⅠCSP(46.23±8.573 days),type ⅡCSP(48.55±9.838 days),typeⅢCSP(56.83±5.879 days),the difference was statistically significant(p < 0.05).Comparing the fetal heart rate of different types of CSP patients(P < 0.05),the difference was statistically significant,indicating that there were differences in the distribution of fetal heart rate among the three groups of different types of CSP patients,and the non-fetal heart rate of type ⅢCSP patients was the highest(83.3%).3.in the treatment of typeⅠCSP,the differences in operation time,hospitalization time and hospitalization expenses between the two groups were statistically significant(p <0.05),and the menstruation recovery time of the two groups was better than that of the operation group,and the difference was statistically significant(p < 0.05).blood loss,short-term postoperative complications and blood β-h CG decreased after 24 hours.In the treatment of typeⅡCSP,there were statistically significant differences in intraoperative blood loss,hospitalization days,hospitalization expenses and operation time between the two groups(P < 0.05).The menstruation resurgent time and bloodβ-h CG decreased to normal time in the operation group,and the difference was statistically significant(P < 0.05).4.Compared with 48 hours after UAE treatment,the amount of intraoperative blood loss can be reduced.The decrease of blood β-h CG in 24 hours is less than that in 48 hours after intervention,and the difference is statistically significant(P > 0.05).There is no significant difference in operation time,operation cost,blood β-h CG decreased to normal time and hospitalization days(P >0.05).Conclusions 1.The more pregnant patients are,the multiple induced abortion,multiple cesarean section and less than 2 years from the previous cesarean section are the risk factors of CSP.2.There are differences in the distribution of the maximum diameter of gestational sac,the number of menopause days and whether the embryo survives among CSP patients.3.Patients with typeⅠand type ⅡCSP can choose to undergo curettage under the guidance of color Doppler ultrasound after UAE treatment,and patients with typeⅡCSP with fertility requirements can choose surgical treatment as appropriate.4.Clearing uterus within 48 hours after 4.UAE treatment can reduce the amount of bleeding during operation.