Treatment of cesarean scar pregnancy by uterine artery embolization and curettage opportunity

Objective To explore the clinical effect of uterine artery embolization on cesarean scar pregnancy (CSP) and curettage opportunity.Methods Sixty-three patients with CSP received curettage after uterine artery embolization with gelfoam were selected.Among of them,21 cases received curettage within 24 h after uterine artery embolization (group A); 20 cases within 1-3 d (group B);22 cases within 4-7 d (group C).The intraoperative haemorrhage,serum β-human chorionic gonadotropin (β-hCG)level resolution time,duration of hospital stay,hospitalization cost,postoperative complications were observed after the termination of the pregnancy.Results The duration of hospital stay and hospitalization cost in group A and group B were (10.5 ± 3.9),(10.2 ± 5.2) d and (7353 ± 962),(7594 ± 1032) yuan,respectively,and there was no significant difference (P ＞ 0.05).Which was lower than that in group C [(13.9 ± 5.4) d,(10 980 ± 1534) yuan],and there was significant difference(P ＜ 0.01).The intraoperative haemorrhage,serum β-hCG level resolution time and postoperative complications in group B and group C were(20.2 ± 8.8),(20.7 ± 9.3) ml and (25.9 ± 9.3),(25.7 ± 8.1) d and 40.0％(8/20),40.9％(9/22),and there was no significant difference(P＞ 0.05).But which was better than those in group A[(35.0 ± 10.7) ml,(20.5 ± 7.7) d,66.7％ (14/21)],and there was significant difference (P ＜0.01).Conclusions The treatment of curettage after the uterine artery embolization is a safe and effective method for CSP.There are fewer complications,shorter hospital stays and fewer hospitalization costs if receiving curettage within 1-3 d after uterine artery embolization. Key words: Uterine artery embolization;  Cesarean scar pregnancy;  Curettage