Abstract:

Objective To analye the outcomes of the treatment methods for cesarean scar pregnancy. Methods Forty-five women with cesarean scar pregnancy were divided into three groups according to different treatment methods. Methotrexate (MTX) was systemically applied in MTX group (n=6), dilation and curettage were performed in dilation and curettage group (n=17), and women in uterine artery embolisation (UAE) group (n=22) underwent uterine artery embolisation in combination of local injection of MTX and dilation and curettage. The outcomes were compared among groups. Results There were significant differences in success rates among MTX group (50%, 3/6), dilation and curettage group (64.71%, 11/17) and UAE group (100%, 22/22)(P＜0.05). The volume of blood loss during operation in UAE group was significantly smaller than that in dilation and curettage group (P＜0.05). There was no significant difference in age, number of cesarean section, gestational age, size of sac and initial level of human chorionic gonadotropin (β-HCG) among three groups (P＞0.05). There were significant differences in duration of hospital stay, time for β-HCG recovery and time for mass disappearance among three groups (P＜0.05). The duration of hospital stay and time for mass disappearance in UAE group were shorter than those in MTX group and dilation and curettage group (P＜0.05). The time for β-HCG recovery in dilation and curettage group was shorter than that in MTX group and UAE group (P＜0.05). In UAE group, 22.73% cases (5/22) had body temperature higher than 38 ℃, and 9.09% cases (2/22) experienced pelvic pain. Conclusion UAE is an effective and safe treatment method for cesarean scar pregnancy.

Key words: cesarean section, cesarean scar pregnancy, methotrexate, dilatation and curettage, uterine artery embolisation