Clinical Study Of Cesarean Scar Ectopic Pregnancy

Objective:The study was desinged to analyze the clinical effect between uterus artery infusion mbolization (UAIE)+curettage、Trans vaginal Cesarean Scar Pregnancy Debridement Surgery and Myometrium Neoplasty and laparoscopic Cesarean Scar Pregnancy Debridement Surgery and Myometrium Neoplasty, to assess the clinical evaluation of Transvaginal Cesarean Scar Pregnancy Debridement Surgery and Myometrium Neoplasty in treatment of caesarean scar pregnancy (CSP).Methods:Retrospective analysis CSP in the guangxi zhuang autonomous region people’s hospital from 2009 to 2014. According some standards of choice and exclusion,117 cases finally were remained,45 cases of UAIE+curettage,40 cases of laparoscopic Cesarean Scar Pregnancy Debridement Surgery and Myometrium Neoplasty,32 cases of Transvaginal Cesarean Scar Pregnancy Debridement Surgery and Myometrium Neoplasty.The clinical characteristics including patients’ basic information, auxiliary examination, treatment process, prognosis were collect and analyzed. Comprehensive evaluation the value of Transvaginal Cesarean Scar Pregnancy Debridement Surgery and Myometrium Neoplasty in the treatment of cesarean scar pregnancy.Results:1.The operative time and blood loss in UAIE group was significantly less than the other two groups, The operative time laparoscopic surgery group was longest. (P<0.001).2.The vaginal bleeding period postoperative was longest in UAIE group. Serum β-HCG level decrease slowly in UAIE group. There was no significant difference in transvaginal surgery and laparoscopic surgery group(P<0.001).3. The hospital stay was shortest in transvaginal surgery group,followed by laparoscopic surgery group, UAIE group was the longest (P<0.05).4.UAIE group’s Hospital costs was the highest (average 13560.08±616.73 yuan),followed by laparoscopic surgery group, transvaginal surgery group was the least (P<0.05).5. There was no significant difference of surgery complication in three groups (P<0.05).6. There was no significant difference of the success rate in three groups (P<0.05).7.The postoperative recovery of transvaginal surgery group is similar to laparoscopic surgery group,but faster than UAIE group (P<0.05).Conclusion:Transvaginal Cesarean scar pregnancy debridement surgery and myometrium neoplasty is a minimally invasive treatment of CSP. It has many advantages such as complete removal of the lesion, retained women’s reproductive function, shorter hospital stay, faster recovery, shorter postoperative bleeding and serum P-HCG decrease quickly postoperation. This procedure is recommended in CSP treatment.