Résumé
Objective To investigate the clinical effect of mifepristone and misoprostol combined with hysteroscopic resection of endometrial uterine incision cesarean scar pregnancy.Methods A retrospective study was conducted to analyze 135 cases of scar pregnancy of endogenous lower uterine cesarean section from January 2015 to October 2017.According to the treatment methods,they were divided into group A (mifepristone and misoprostol combined with hysteroscopy),group B (methotrexate combined with hysteroscopy),group C (Uterine artery embolization + curettage).Each group had 45 cases,and the therapeutic effects of the three methods were compared.Results There was no significant difference in gestational sac size and serum human chorionic gonadotropin [beta-human chorionic gonadotropin (HCG)] levels among the three groups before operation (P ＞ 0.05).After operation,the operation time,intraoperative bleeding volume,serum beta-HCG dropping to normal time,vaginal bleeding time and hospitalization time in A and C group were significantly lower than that in B group (P ＞ 0.05).There was no significant difference between group A and group C in operation time,serum beta-HCG to normal time,vaginal bleeding time and hospitalization time.(P ＞ 0.05).The menstruation time of group A was significantly shorter than that of group B and group C (P ＜0.05).The effective rates of group A,B and C were 100.00％,97.78％ and 100.00％ respectively,with no significant difference in the three groups (P ＞ 0.05);The complication rates of A,B and C groups were 2.22％,13.33％ and 4.44％ respectively,with no significant difference in the three groups (P ＞ 0.05).Conclusions The three methods are effective in the treatment of cesarean scar pregnancy.The mifepristone and misoprostol combined with hysteroscopy have the advantages of less operative trauma and faster postoperative recovery.
Résumé
Objective To remind the attention to contraceptive in cesarean section group by analyzing the treatment of 104 cases cesarean scar pregnancy (CSP).Methods From April 2009 to November 2012,104 patients with CSP treated in Department of Obstetrics and Gynecology,Wuhan Union Hospital were studied retrospectively.The incidence,treatment,and average in hospital days and average cost of hospitalization were analyzed.Results From 2009 to 2012,the number of CSP was 10,19,29,and 46 cases annually which accounted for the proportion of the corresponding period of gynecological patients were 0.33％,0.63％,0.97％,and 1.53％.Bilateral uterine artery embolization plus curettage was the most effective treatment.The average transfusion rate was 25％.The average amount of in-hospital days were (14 ± 8) days,the average cost of hospitalization were (12954.97 ± 3888.89) yuan.Conclusions The CSP incidence was increasing sharply in China.Although the current treatment methods could greatly reduce complications of CSP,it did harm to the patients and their family.The key to reduce the occurrence of CSP included reducing the rate of cesarean section,and strengthening contraceptive education after cesarean section.