HIFU combined with curettage versus transvaginal surgery for patients with type Ⅱ cesarean scar pregnancy

Objective To compare the clinical effect of high-intensity focused ultrasound (HIFU) combined with curettage versus transvaginal surgery for patients with typeⅡscar pregnancy, and provide evidences for selection of appropriate treatment. Methods Totally 83 patients with type Ⅱ uterine scar pregnancy admitted to the First People's Hospital of Neijiang from January 2017 to January 2019 were selected, of which 39 cases (HIFU group) were treated with HIFU combined curettage and 44 cases (transvaginal group) were treated with transvaginal surgery. There was no statistically significant difference in the general data of the two groups. The volume of intraoperative bleeding, operating time, postoperative decrease in β-HCG level, length of hospital stay, time to menstrual recovery, and intraoperative and postoperative adverse reactions were compared between the two groups. Results Allpatients had completed the treatment successfully. There was no significant difference between the two groups in the decline of β-HCG value and time of menstrual recovery (all P>0.05). The intraoperative bleeding (23.33±19.41 ml vs 64.32±125.88 ml),operating time (20.26±14.00 min vs 57.27±17.47 min) and length of hospital stay (10.51±3.85 d vs 5.80±1.84 d) in the two groups were all significantly different (all P<0.05) between the HIFU group and the transvaginal group. Conclusion Both HIFU combined with curettage and transvaginal surgery are effective and safe for treatment of type Ⅱ uterine scar pregnancy, and there is no significant difference in the therapeutic effect between the two methods. However, the blood loss and the operating time is relatively greater in the transvaginal surgery group, while patients treated with HIFU have a longer hospital stay.