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. 2018 Jul 6:24:4659-4666.
doi: 10.12659/MSM.907404.

Clinical Efficacy and Safety of Uterine Artery Embolization (UAE) versus Laparoscopic Cesarean Scar Pregnancy Debridement Surgery (LCSPDS) in Treatment of Cesarean Scar Pregnancy

Junhong Guo  1 , Jiangtao Yu  2 , Qing Zhang  1 , Xiaojie Song  1
Affiliations

Clinical Efficacy and Safety of Uterine Artery Embolization (UAE) versus Laparoscopic Cesarean Scar Pregnancy Debridement Surgery (LCSPDS) in Treatment of Cesarean Scar Pregnancy

Junhong Guo et al. Med Sci Monit. .

Abstract

BACKGROUND The present study aimed to compare the clinical efficacy and safety of uterine artery embolization (UAE) vs. laparoscopic cesarean scar pregnancy debridement surgery (LCSPDS) in the treatment of patients with cesarean scar pregnancy (CSP). MATERIAL AND METHODS A retrospective analysis was performed on 87 CSP patients from March 2012 to February 2017. For the included 87 cases, 51 were treated with UAE and 36 were treated with LCSPDS. The operation success rate, intraoperative blood loss, operation time, length of hospital stay, perioperative complications, and β-HCG level were compared. RESULTS For the UAE group, 41 patients underwent successful surgeries (80.4% success rate), and 36 cases in the LCSPDS group were successfully treated, with no case of perioperative death. In the UAE group, the operation time, intraoperative blood loss, and length of hospital stay were 82.23±45.21 min, 112.58±68.54 mL, and 12.56±3.03 days, respectively. In the LCSPDS group, the operation time, intraoperative blood loss, and length of hospital stay were 85.45±30.02 min, 108.56±54.12 mL and 7.65±2.48 days, respectively. The length of hospital stay for the UAE group was significantly longer than in the LCSPDS group (P<0.05). CONCLUSIONS UAE and LCSPDS each have their own advantages and disadvantages in treating CSP. Thus, appropriate individualized surgical programs based on specific patient circumstances are needed to avoid indiscriminately performing complete uterine cavity curettage.

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Conflict of interest statement

Conflict of interest

None.

Figures

Figure 1
Figure 1
Transvaginal sonography of uterine incision pregnancy (Transvaginal ultrasonography showed mixed masses in the lower segment of the anterior wall of the uterus, white arrow).
Figure 2
Figure 2
Magnetic resonance imaging (MRI) of uterine incision pregnancy (Scar defect of anterior wall of uterus, white arrow; Intrauterine yolk sac, red arrow).
Figure 3
Figure 3
Angiograph of uterine artery embolization (A, D: Intraoperative iliac arteriography; B, E: Intraoperative arteriography of uterus artery; C, F: Uterine artery embolization).
Figure 4
Figure 4
The post-operation serum β-HCG distribution of the 2 groups.
See this image and copyright information in PMC

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