Hysteroscopic plus laparoscopic surgery following UAE pretreatment for cesarean scar pregnancy

Objective To explore the clinical value of hysteroscopic plus laparoscopic surgery in the treatment of cesarean scar pregnancy patients with uterine artery embolization (UAE) pretreatment. Methods A retrospective analysis of clinical data about 59 cesarean scar pregnancy patients admitted to our hospital from January 2012 to January 2017 was performed. Patients in study group (n=33) were treated with UAE + hysteroscopic plus laparoscopic surgery, and the control group (n=26) with UAE + ultrasound guided curettage. The clinical outcomes of the two groups were recorded and compared. Results The initial treatment success rate of the study group was significantly higher than that of control group (100% vs 80.8%, P=0.008). Compared with control group, the operating time of the study group was longer (63.5±21.9) min vs (28.2±11.0) min, P< 0.001, while the average hospital stay was less (6.9±2.5) d vs (8.4±3.2) d, P=0.047. The amount of operative bleeding in two groups had no statistically significant difference (84.1±30.3)ml vs (71.4±32.9) ml, P=0.130. The time of vaginal bleeding and β-HCG return to normal in the study group were significantly less than those of control group (12.6±5.8) d vs (17.9±8.2) d, P=0.005; (22.0±7.6) d vs (29.1±9.3) d, P=0.002. And the curative effect rate of study group was higer than that of control group (93.9% vs 50.0%, P=0.001). Conclusion UAE +hysteroscopic + laparoscopic surgery is effective for all types of cesarean scar pregnancy with higher success rate.