Analysis of Clinical Effects of Different Treatments for Cesarean Scar Pregnancy

doi:10.3877/cma.j.issn.1673-5250.2012.06.018

Objective

To discuss the clinical effects of different ways for cesarean scar pregnancy (CSP).

Methods

From February 2007 to August 2011, 15 patients with CSP who recruited into First Affiliated hospital of Fujian Medical University (n=11) and First Affiliated Hospital of Jinan University (n=4) were reviewed retrospectively. The operation methods included four kinds of operation methods, MTX and Mifepristone/+ B ultrasonic guided curettage of uterine, uterine arterial embolism (UAE)/+ B ultrasonic guided curettage of uterine, pregnancy lesion excision + uterine scar neoplasty, and hysterectomy. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of First Affiliated hospital of Fujian Medical University and First Affiliated Hospital of Jinan University. Informed consent was obtained from all participates' parents.

Results

The duration of hospitalization of four kinds of operation methods (MTX and Mifepristone/+ B ultrasonic guided curettage of uterine, UAE/+ B ultrasonic guided curettage of uterine, pregnancy lesion excision + uterine scar neoplasty, and hysterectomy) were (24.2±0.8) d, (10.2±1.3) d, (8.5±1.0) d, (11.0±0.0) d, respectively, with significant differences (P=0.001). The time of blood β-hCG level back to normal were (42.5±1.2)d, (22.7±3.2)d, (13.2±1.0)d, (18.0±0.0)d, respectively, with significant differences (P=0.001). The follow-up time of four kinds of operation methods were (150.2±4.5) d, (65.4±4.3) d, (30.3±3.2) d, (30.0±0.0) d, respectively, with significant differences (P=0.001). The treatment costs of four kinds of operation were (2321.3±32.5)Yuan, (13 320.2±85.9) Yuan, (8985.2±68.6) Yuan, (9985.5±0.0) Yuan, respectively, with significant differences (P=0.001).

Conclusions

Different operation methods should be conducted according to different patient. MTX combined with Mifepristone, or UAE without curettage of uterine might be effective ways in treating CSP.

Key words: cesarean scar pregnancy, treatment method

表1 各术式比较分析(±s)

Table 1 Comparison of items of different operations (±s)

术式	n	住院时间(d)	血β－hCG水平降至正常时间(d)	随访时间(d)	治疗费用(元)
MTX＋米非司酮/＋超声监测下清宫术	6	24.2±0.8	42.5±1.2	150.2±4.5	2321.3±32.5
UAE和(或)超声监测下清宫术	2	10.2±1.3^a	22.7±3.2^a	65.4±4.3^a	13 320.2±85.9^a
妊娠病灶切除术＋子宫疤痕修补术	6	8.5±1.0^a	13.2±1.0^a	30.3±3.2^a	8985.2±68.6^a
子宫全切除术	1	11.0±0.0^a	18.0±0.0^a	30.0±0.0^a	9985.5±0.0^a
F	?	5.92	4.86	5.68	4.98
P	?	0.001	0.001	0.001	0.001

表1 各术式比较分析(±s)

Table 1 Comparison of items of different operations (±s)

术式	n	住院时间(d)	血β－hCG水平降至正常时间(d)	随访时间(d)	治疗费用(元)
MTX＋米非司酮/＋超声监测下清宫术	6	24.2±0.8	42.5±1.2	150.2±4.5	2321.3±32.5
UAE和(或)超声监测下清宫术	2	10.2±1.3^a	22.7±3.2^a	65.4±4.3^a	13 320.2±85.9^a
妊娠病灶切除术＋子宫疤痕修补术	6	8.5±1.0^a	13.2±1.0^a	30.3±3.2^a	8985.2±68.6^a
子宫全切除术	1	11.0±0.0^a	18.0±0.0^a	30.0±0.0^a	9985.5±0.0^a
F	?	5.92	4.86	5.68	4.98
P	?	0.001	0.001	0.001	0.001

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