2014, Volume 16, Issue 5
Strategic Study of CAE >> 2014, Volume 16, Issue 5
Analysis on treatment effects of 72 cases cesarean scar pregnancy by hysteroscopy and laparoscopy
Beijing Obstetrics and Gynaecology Hospital，Capital Medical University，Beijing 100006，China
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Abstract
To investigate the effects of hysteroscopic and laparoscopic operation in the treatment of cesarean scar pregnancy (CSP)，a retrospective analysis of 72 cases of CSP patients in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from January to December in 2013. All the patients were dignosised through serum human chorionic gonadotropin and three-dimensional color Doppler ultrasound examination. According to the local range of lesion，HCG results and Doppler ultrasound blood flow results，preoperative selective uterine artery embolization or methotrexate treatment was carried out，then further hysteroscopy，laparoscopy or combined with operation therapy was carried out. The results showed，30 cases underwent ultrasonic monitoring hysteroscopic lesion resection，12 cases were treated with laparoscopic monitoring CSP lesion resection under hysteroscopy，30 cases were treated with laparoscopy to resect lesion and repair cesarean scar，all of them received good treatment effect. The average amount of bleeding was (83±57) mL，postoperative anal exhaust time was (20±6.6) h，the time of vagina bleeding was (3.2±4.8) d，serum HCG decreased to normal time was (8.6±3.9) d，the time to discharge was (3.2±2) d. Patients with postoperative pathological diagnosis and preoperative CSP diagnosis coincidence rate was 100 %. Women with the history of cesarean section pregnancy have the possibility of CSP. Ultrasound or laparoscopy by hysteroscopy monitored CSP lesion resection is an effective treatment for CSP. It has many advantages such as excision exact，small trauma，laparoscopic lesion excision and cesarean scar repair surgery，fertility requirements of patients while repairing a cesarean scar anatomy abnormality on follow-up，and can reduce pregnancy at CSP and rupture of the uterus，placenta accreta obstetric complications such as risk.
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References
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