Cesarean Scar Pregnancy Clinical Analysis Of 78 Cases

Objective:To survey effective treatment strategies for cesarean scar pregnancy (CSP).Method:The clinical data of 78 patients diagnosed with CSP from 2010-2013 were reviewed. Reorganization and the analysis the clinical data, serum β-HCG level, gestational age, diameter of the sac, number of deep implantations, success rate, hospitalization cost, time of recovery and amount of bleeding.Results:1. Among these patients, Seventeen patients visited our hospital as a first point of treatment; of these,2 were misdiagnosed. Sixty-one patients were referred from other hospitals; of these,21 were initially misdiagnosed.2. As treatment,9 patients underwent laparotomy,50 patients underwent curettage after uterine artery embolization (UAE) with or without local methotrexate (MTX) infusion,10 patients received dilatation and curettage,6 patients underwent transvaginal sonographic guided local intragestational MTX injection, and 3 patients received systemic MTX injection. All patients finally recovered.3. Patients with excessive vaginal hemorrhage underwent either emergency UAE treatment or laparotomy. These two treatments had similar success rates.Conclusion:1. Cesarean scar pregnancy is a special type of ectopic pregnancy,the early clinical manifestations are nonspecific, it is easy to be misdiagnosed early.2. The early diagnosis of cesarean scar pregnancy rely on the cesarean section surgeries menopause history and the ultrasound. The ultrasound inspection is an important basis to diagnosis method.3. Traditional surgical options like laparoscopic removal, Excision of scar pregnancy on laparotomy, or hysterectomy are the most reliable ways to treat CSP and its complications. Curettage after UAE with or without local MTX infusion is currently accepted as an effective and safe treatment for CSP.