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| 129 cases of cesarean section for caesarean scar pregnancy under Ultrasound guided |
| LI Yun-hui1 DAI Hong-ying2▲ LI Wei-wei1 NIU Zhao-guo2 YANG Meng-meng1 |
1.Medical college of Qingdao university,Shandong Province,Qingdao 266000,China;
2.Department of Gynaecology,Affiliated Hospital of Qingdao university,Shandong Province,Qingdao 266000,China; |
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Abstract Objective To evaluate the safety feasibility and influence factors of curettage for caesarean scar pregnancy under Ultrasound guided.Methods The clinical data of 129 patients with CSP who underwent ultrasound-guided curettage in affiliated hospital of Qingdao university from January 2014 to May 2017 were analyzed retrospectively.According to the observation index and evaluation criteria,the patients were divided into two groups：success group(n=118)and failure group(n=11).The gestational weeks,gestational sac size,preoperative blood β-HCG,myometrial thickness of uterine anterior wall at focus,intraoperative blood loss and treatment methods after curettage failure were compared between the two groups.Results There was no significant difference in pregnancy age,gestational sac size and preoperative blood β-HCG between the two groups(P＞0.05).In the successful group,the time of menopause was shorter than that in the failed group,the thickness of myometrium in the lesion was better than that in the failed group,and the amount of intraoperative bleeding was less than that in the failed group,the difference was statistically significant(P＜0.05).Of the 11 failed cases,5 underwent cesarean scar pregnancy tissue removal.5 cases were successfully treated with mifepristone.One patient underwent cesarean scar pregnancy tissue removal after embolization due to massive hemorrhage during hysterectomy.Conclusion When CSP gestational age＜7 weeks,thickness of muscle layer≥4.0 mm,underwent ultrasound guided curettage with high security.For the failed CSP of curettage,if the local blood flow signal is rich,the surgical treatment should be performed.If the local blood flow signal is not rich,the conservative treatment should be performed.
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