RESUMO
Objective To explore the clinical diagnosis and treatment of cesarean scar pregnancy (CSP).Methods The clinical data of 83 CSP patients who first visited to our hospital during the period from January 2014 to December 2016 were collected for a retrospective analysis.Among the 83 cases, 79 were diagnosed by ultrasound, 2 were diagnosed by MRI, and 2 were misdiagnosed (2.4%).Curettage under ultrasound monitoring was used in 11 cases, including 10 cases of type Ⅰ and 1 case of type Ⅱ according to the 2016 classification standard of Chinese Medical Association.Curettage under ultrasound monitoring after methotrexate(MTX) was used in 34 cases, including 30 cases of type Ⅰ and 4 cases of type Ⅱ.Curettage under ultrasound monitoring after uterine artery embolization (UAE) was used in 37 cases, including 3 cases of type Ⅰ, 30 cases of type Ⅱ, and 4 cases of type Ⅲ.Besides, 1 case of type Ⅲ was treated with curettage under laparoscopic monitoring after UAE.Results All the operations were successful, without hysterectomy or conversion to open surgery.No persistent pregnancy was occurred.A total of 65 cases were followed up and 18 cases were lost.The β-hCG was decreased to normal after 2-5 weeks.After 4-9 weeks, menstruation was recovered.Conclusion According to different clinical types of CSP and gestational weeks, curettage under ultrasound or laparoscopic monitoring after different pretreatement is simple, safe and effective in primary hospitals.