European journal of obstetrics, gynecology, and reproductive biology · 2017
The Treatment of Cesarean Scar Pregnancy with Uterine Artery Embolization and Curettage as Compared to Transvaginal Hysterotomy.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Chen Huihui, Zhou Jieru, Wang Husheng, Tan Weilin, Yao Min, Wang Xipeng
Аннотация
OBJECTIVES: To investigate the outcome and menstrual status in patients after treatment of cesarean scar pregnancy (CSP) by transvaginal hysterotomy or uterine artery embolization combined with uterine curettage.
STUDY DESIGN: A retrospective cohort study. An analysis of CSP patients was performed using records from Shanghai First Maternity & Infant Hospital affiliated with Tongji University for the period between July 16, 2014 and January 22, 2016. Twenty-seven patients were treated with transvaginal hysterotomy and in this group, 49 patients received uterine curettage after UAE. The clinical information on these patients and clinical outcomes especially the status of menstruation were reviewed.
RESULTS: There was only one complication in transvaginal hysterotomy group, while 3 cases of villus residue occurred in UAE group. Nineteen patients (70.4%) in transvaginal hysterotomy group self-assessed their menstrual volumes, which had no remarkable changes; 6 patients (22.2%) felt that their menstrual volumes had decreased. Thirty-five patients in UAE group (71.4%) reported that their menstrual volumes decreased (P<0.05). The range of pictorial blood loss score was 55-82 in transvaginal hysterotomy group and 9-74 in UAE group, and the mean pictorial blood loss score was decreased from 68.4 to 65.8 in transvaginal hysterotomy group (a 3.2±4.4% reduction) and from 66.4 to 38.8 in UAE group (a 41.7±26.4% reduction) (P<0.05).
CONCLUSIONS: Transvaginal hysterotomy appears to be more advantageous than UAE combined with uterine curettage. The menstrual interval and duration changed significantly in UAE group.
STUDY DESIGN: A retrospective cohort study. An analysis of CSP patients was performed using records from Shanghai First Maternity & Infant Hospital affiliated with Tongji University for the period between July 16, 2014 and January 22, 2016. Twenty-seven patients were treated with transvaginal hysterotomy and in this group, 49 patients received uterine curettage after UAE. The clinical information on these patients and clinical outcomes especially the status of menstruation were reviewed.
RESULTS: There was only one complication in transvaginal hysterotomy group, while 3 cases of villus residue occurred in UAE group. Nineteen patients (70.4%) in transvaginal hysterotomy group self-assessed their menstrual volumes, which had no remarkable changes; 6 patients (22.2%) felt that their menstrual volumes had decreased. Thirty-five patients in UAE group (71.4%) reported that their menstrual volumes decreased (P<0.05). The range of pictorial blood loss score was 55-82 in transvaginal hysterotomy group and 9-74 in UAE group, and the mean pictorial blood loss score was decreased from 68.4 to 65.8 in transvaginal hysterotomy group (a 3.2±4.4% reduction) and from 66.4 to 38.8 in UAE group (a 41.7±26.4% reduction) (P<0.05).
CONCLUSIONS: Transvaginal hysterotomy appears to be more advantageous than UAE combined with uterine curettage. The menstrual interval and duration changed significantly in UAE group.