Treatments for cesarean scar pregnancy: 11-year experience at a medical center

作者：Suxia Huo, Liang Shen, Ying Ju, Keke Liu, Wei Liu · 发表于：The Journal of Maternal-Fetal & Neonatal Medicine · 年份：2023 · DOI：10.1080/14767058.2022.2162818 · 被引用次数：23 · 研究领域：Ectopic Pregnancy Diagnosis and Management、Appendicitis Diagnosis and Management、Pregnancy-related medical research

BACKGROUND: Cesarean scar pregnancy (CSP) is a long-term complication after cesarean section that can cause severe maternal morbidity and mortality. Although a variety of treatments have been described, there is no consensus as to the optimal management approach. Many grading systems for CSP have been proposed, among which the classification made by the consensus of Chinese experts in 2016 was shown to provide improved treatment guidance for clinical practice. The purpose of the present study was to analyze the success rate of different treatments for each type of CSP as classified according to the Chinese Expert's Consensus (2016), and to develop a management strategy for CSP. METHODS: A retrospective study was performed among patients diagnosed with CSP at Shandong Provincial Hospital between January 2009 and December 2019. We reviewed clinical characteristics, treatment methods, and subsequent outcomes; and analyzed these endpoints using the statistical software package SPSS 22.0 (SPSS, Inc., Chicago, IL). RESULTS: For type I CSP, systemic methotrexate (MTX) administration exhibited a success rate of 79.2% for type Ia and 14.3% for type Ib. Local and systemic MTX administration success rates were 88.9% for type Ia and 66.7% for type Ib. Dilation and curettage (D&C), curettage after uterine artery embolization (UAE + C), and hysteroscopic curettage (H + C) were 100% successful. For type II, UAE + C, H + C, and laparoscopy combined with hysteroscopic curettage (L + H+C) were...