To explore the effect of two different embolization agents polyvinyl alcohol particles (PVA) with a diameter of 560-710 μm and gelfoam particles (GP) with a diameter of 500-710 μm on the volumes of bleeding in uterine artery chemoembolization (UACE) combined with uterine curettage under ultrasound monitoring in pregnant women with caesarean scar pregnancy (CSP).

From July 1 of 2015 to March 1 of 2019, a total of 142 cases of CSP pregnant women who received UACE combined with uterine curettage under ultrasound monitoring in Department of Radiology, West China Second University Hospital, Sichuan University were selected as the research subjects by simple random sampling method, and there were 102 cases of CSP Ⅱ, and 40 cases of CSP Ⅲ. According to types of CSP and different embolization agents used in UACE, the 142 pregnant women with CSP were divided into type Ⅱ PVA group (n=51, CSP Ⅱ pregnant women with the use of PVA as embolization agents), type Ⅱ GP group (n=51, CSP Ⅱ pregnant women with the use of GP as embolization agents), type Ⅲ PVA group (n=20, CSP Ⅲ pregnant women with the use of PVA as embolization agents), type Ⅲ GP group (n=20, CSP Ⅲ pregnant women with the use of GP as embolization agents). The age, the maximum diameter of gestational sac, time of menopause at admission, gravidity, number of caesarean sections, levels of human chorionic gonadotropin (hCG) before operation, length of hospital stay, and volume of bleeding during uterine curettage of all pregnant women were collected by retrospective method. Wilcoxon rank sum test and independent-samples t test were used to compare the volume of bleeding during uterine curettage and length of hospital stay between type Ⅱ PVA group and type Ⅱ GP group, type Ⅲ PVA group and type Ⅲ GP group. This study was in line with the requirements of World Medical Association of Helsinki revised in 2013.

①There were no statistically significant differences between type Ⅱ PAV group and type Ⅱ GP group, type Ⅲ PAV group and type Ⅲ GP group in the age, time of menopause at admission, gravidity, number of caesarean sections, level of hCG before operation (P>0.05). ②The maximum diameters of gestational sac in type Ⅱ PAV group and type Ⅲ PAV group were longer than those in type Ⅱ GP group and type Ⅲ GP group, respectively, and both differences were statistically significant (t=3.377, 2.096; P=0.001, 0.043). The correlation analysis of the maximum diameter of gestational sac and volume of bleeding during uterine curettage showed that the maximum diameter of gestational sac of pregnant women with type Ⅱ CSP was weakly correlated with the volume of bleeding during uterine curettage (r_s=0.235, P=0.017), and in pregnant women with type Ⅲ CSP, there was no significant correlation between these two indexes (r_s=0.295, P=0.064). ③The volumes of bleeding during uterine curettage in type Ⅱ PVA group and type Ⅱ GP group were 10 mL (2-200 mL) and 10 mL (2-100 mL), respectively, and the length of hospital stay were (5.3±1.5) d and (5.2±1.7) d, respectively, and there were no statistically significant differences between these two groups in these two indexes (P>0.05). The volumes of bleeding during uterine curettage in type Ⅲ PVA group and type Ⅲ GP group were (10.7±7.5) mL and (11.7±13.9) mL, respectively, and the length of hospital stay were (5.5±1.1) d and (4.8±1.8) d, respectively, and there were no statistically significant differences between these two groups in these two indexes (P>0.05).

The effects of reducing the volume of bleeding during uterine curettage are the same with the use of PVA and GP as embolization agents to embolize bilateral uterine artery of CSP pregnant women in UACE combined with uterine curettage under ultrasound monitoring.