Evaluation on safety and effectiveness of ultrasonographic scoring system in different treatment methods for cesarean scar pregnancy

Abstract

Objective To evaluate and compare the efficacy and safety of different managements for women with cesarean scar pregnancy based on a ultrasonographic scoring system. Methods A total of 299 pregnant women with cesarean scar undergoing delivery surgeries in our department from November 2018 to December 2019 were recruited retrospectively. According to the preoperative results of the ultrasonographic scoring system, they were divided into low-risk group (score ≤4) and high-risk group (score > 4). The patients in the low-risk group were treated with ultrasound-guided curettage. And those of the other group were treated with uterine artery embolization and ultrasound-guided curettage. The basic information, perioperative data and postoperative follow-up data of the patients were collected and analyzed. Results There was no statistical difference in the amount of intraoperative blood loss between the 2 groups (P > 0.05), neither the incidence of secondary uterine artery embolization between them (P > 0.05). But significant difference was found in the incidence of secondary laparoscopic procedure for removing scar tissues between the 2 groups (P < 0.05). What's more, there were obvious differences in the length of hospital stay and total cost, the time of postoperative serum β-HCG level dropping to normal, the time of disappearance of the abnormal echoes in the lower segment of the uterus, and the restoration of normal menstruation between the 2 groups (P < 0.05). However, there was no statistical significance of the outcome of the second pregnancy between them after treatment. Conclusion According to the preoperative ultrasonographic scoring system for cesarean scar pregnancy, patients in different treatment methods.

Keywords

• cesarean scar pregnancy
• a ultrasonographic scoring system
• uterine artery embolization
• curettage