ABSTRACT
Objective: To explore the effect and impact factors of prophylactic uterine artery embolization (UAE) for reducing bleeding during curettage in treatment of cesarean scar pregnancy (CSP). Methods: Data of 841 CSP patients who underwent prophylactic UAE and uterine curettage were retrospectively analyzed. The volume of blood loss during uterine curettage was evaluated, ≥200 ml was judged as poor hemostasis. The influencingmpact factors of poor hemostatic effectsis were analyzed, and complications within 60 days after operation were calculated. Results: Among 841 patients, volume of blood loss during uterine curettage was found ≥200 ml in 53 patients, parity, and embolic agent diameter (>1 000 μm), multi-vessel blood supply and incomplete embolization were independent risk factors (all P<0.05). Within 60 days after UAE, the main postoperative complications included abdominal pain, low fever, nausea and vomiting, and buttock pain, with incidence rates of 71.22% (599/841), 47.44% (399/841), 39.12% (329/841) and 36.39% (306/841), respectively. Conclusion: Prophylactic UAE before uterine curettage in patients with CSP is safe and effective to reduce intraoperative bleeding, and parity, embolic agent diameter, multivessel blood supply as well as incomplete embolization are impact factors.