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The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study.
You, Xinxin; Ruan, Yan; Weng, Shouxiang; Lin, Chenya; Gan, Meifu; Qi, Feng.
Afiliación
  • You X; Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai, Zhejiang Province, China.
  • Ruan Y; Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai, Zhejiang Province, China.
  • Weng S; Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai, Zhejiang Province, China.
  • Lin C; Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai, Zhejiang Province, China.
  • Gan M; Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai, Zhejiang Province, China. gmeifu@sohu.com.
  • Qi F; Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai, Zhejiang Province, China. wolovetheworld@163.com.
BMC Pregnancy Childbirth ; 24(1): 151, 2024 Feb 21.
Article en En | MEDLINE | ID: mdl-38383385
ABSTRACT

BACKGROUND:

Cesarean scar pregnancy (CSP) is a long-term complication of cesarean section characterized by the localization of a subsequent gestational sac within the scar area or niche developed as a result of a previous cesarean section. Its incidence has increased substantially because of the high global cesarean section rate in recent decades. Several surgical and drug treatments exist for this condition; however, there is currently no optimal treatment. This study compared the effectiveness of direct hysteroscopic removal of the gestational tissue and hysteroscopy combined with vacuum suction for the treatment of CSP.

METHODS:

From 2017 to 2023, 521 patients were diagnosed with CSP at our hospital. Of these patients, 45 underwent hysteroscopy. Among them, 28 underwent direct hysteroscopic removal (hysteroscopic removal group) and 17 underwent hysteroscopy combined with vacuum suction (hysteroscopic suction group). The clinical characteristics and outcomes of the hysteroscopic removal group and hysteroscopic suction group were analyzed.

RESULTS:

Among the 45 patients, the amount of bleeding and hospitalization cost were significantly higher in the hysteroscopic removal group than in the hysteroscopic suction group (33.8 mL vs. 9.9 mL, P < 0.001; and 8744.0 yuan vs. 5473.8 yuan, P < 0.001; respectively). The operation time and duration of hospitalization were significantly longer in the hysteroscopic removal group than in the hysteroscopic suction group (61.4 min vs. 28.2 min, P < 0.001; and 3.8 days vs. 2.4 days, P = 0.026; respectively). Three patients in the hysteroscopic removal group had uterine perforation and received laparoscopic repair during operation. No complications occurred in the hysteroscopic suction group. One patient in the hysteroscopic removal group received ultrasound-guided suction curettage due to postoperative moderate vaginal bleeding, and one patient in the hysteroscopic suction group received ultrasound-guided suction curettage due to postoperative gestational residue and elevated serum beta-human chorionic gonadotropin levels. Reproductive function was preserved in all patients.

CONCLUSIONS:

Hysteroscopy is an effective method for treating CSP. Compared with direct hysteroscopic removal, hysteroscopy combined with vacuum suction is more suitable for CSP. However, multicenter prospective studies with large sample sizes are required for verification of these findings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embarazo Ectópico / Histeroscopía Límite: Female / Humans / Pregnancy Idioma: En Revista: BMC Pregnancy Childbirth Asunto de la revista: OBSTETRICIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embarazo Ectópico / Histeroscopía Límite: Female / Humans / Pregnancy Idioma: En Revista: BMC Pregnancy Childbirth Asunto de la revista: OBSTETRICIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido