Kang Zhou MD, Presenter: Nothing to Disclose

To compare the clinical effect of dilation and curettage after uterine artery chemoembolization (UACE) and laparotomy lesion excision for treatment of cesarean scar pregnancy (CSP)

A total of 77 patients with CSP were analyzed. The patients were divided into two groups: Group A included 22 patients who were treated by laparotomy lesion excision; group B included 55 patients who received UACE 24-72 h before dilation and curettage. The main comparative indicators were operation time, blood loss, time for β-human chorionic gonadotrophin (β-hCG) to decline to normal values, the duration of hospital stay, complications, rate of secondary treatment and menstrual situation after operation.

None of the 77 patients received hysterectomy. In group A, 1 patient had to receive UACE due to massive hemorrhage. The rate of secondary treatment was 4.55% (1/22) in group A. In group B, 1 patient received perforation repair, 1 received laparotomy lesion excision due to active bleeding. Theβ-hCG level persisted in 3 patients, 2 of them received MTX injection and 1 received dilation and curettage again. The rate of secondary treatment was 9.09% (5/55) in group B (P >0.05). The operation time in group A was more than that in group B（[114.45±34.32]min vs. [35.35±20.21]min, P＜0.01）. The mean blood loss in group A was more than that in group B ([186.53±43.30]ml vs. [52.36±28.04]ml, P＜0.01). The average time for β-hCG to decline to normal in group A was less than that in B groups ([15.32±3.21]d vs. [24.11±7.32]d, P＜0.01). The duration of hospital stay in group A was more than that in group B ([19.34±5.72]d vs. [13.46±4.87]d, P＜0.01). All patients regained normal menstruation within half a year.

Dilation and curettage after UACE and laparotomy lesion excision are both safe and effective treatments for CSP. Dilation and curettage after UACE is minimally invasive, with less operation time, less blood loss in operation and less duration of hospital stay. Especially, UACE could provide remarkable clinic effect for the patients with acute vaginal bleeding.

Dilation and curettage after UACE is a safe and effective treatment for CSP, with less operation time, less blood loss in operation and less duration of hospital stay than laparotomy lesion excision.

Zhou, K, Treatment of Cesarean Scar Pregnancy: Comparison between Dilation and Curettage after Uterine Artery Chemoembolization with Laparotomy Lesion Excision.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14008540.html