Abstract
Objectives
To compare the clinical effects of dilatation and curettage (D&C) regimen and operative hysteroscopy coupled with curettage regimen in the treatment of cesarean scar pregnancy (CSP) following preventive uterine artery embolization (UAE).
Materials and methods
Thirty-three women were treated with D&C after UAE (group A) and 33 women were treated with operative hysteroscopy coupled with curettage after UAE (group B). The clinical outcomes of the two groups were compared.
Results
There was no significant difference between the two groups with respect to the success rate, the intraoperative blood loss, the hysterectomy rate, the hospitalization time, the decline of serum β-hCG after surgery, the time of serum β-hCG resolution, the time of vaginal bleeding after surgery, the time to CSP mass disappearance, and the subsequent intrauterine pregnancies. The hospitalization cost in group B was higher than group A.
Conclusions
Both D&C and operative hysteroscopy coupled with curettage were successful in terminating a CSP. Hysteroscopy coupled with curettage regimen did not have significant advantages and good prognosis in dealing with the gestational sac type of CSP following preventive UAE compared with D&C regimen. Treatment should be individualized and several conditions must be considered.
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Acknowledgments
This work was supported by the Program for Zhejiang Leading Team of S & T Innovation, P. R. China (No.: 2011R50013-25), Program for Key Subjects of Zhejiang Province in Medicine & Hygiene, P. R. China (No.: 11-ZC18), Program for Key Subjects Group of Reproductive Medicine at Zhejiang Province, P. R. China (No.: XKQ-009-002), Program for Changjiang Scholars and Innovative Research Team in University, P. R. China (No.: IRT1184), and the National Basic Research Program of China (2012CB944902).
Conflict of interest
We declare that we have no conflict of interest. We do not have financial relationships with any organizations. We have had full control of all primary data and we agree to allow the Journal to review our data if requested.
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Qian, ZD., Huang, LL. & Zhu, XM. Curettage or operative hysteroscopy in the treatment of cesarean scar pregnancy. Arch Gynecol Obstet 292, 1055–1061 (2015). https://doi.org/10.1007/s00404-015-3730-1
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DOI: https://doi.org/10.1007/s00404-015-3730-1