Uterine artery embolization and uterine artery chemoembolization for the treatment of cesarean scar pregnancy：a comparative study / 介入放射学杂志

ABSTRACT

Objective To evaluate the clinical efficacy of uterine artery chemoembolization (UACE) and uterine artery embolization (UAE) with subsequent curettage in treating cesarean scar pregnancy (CSP). Methods A total of 79 patients with clinically-confirmed CSP were randomly divided into two groupsgroup A (UACE group,n=43) and group B (UAE group,n=36). Patients in each group were subdivided into two subgroups endogenous type subgroup and exogenous type subgroup. Interventional management (UACE for group A and UAE for group B) with subsequent curettage was carried out in all patients of both groups. The amount of blood loss during curettage, the recovered time of human chorionic gonadotropin (HCG) level, the twice treatment rate and the success rate of treatment were measured and were used as the therapeutic evaluation parameters. The results were compared between group A and group B as well as between the subgroups. Results After UACE or UAE, the uterine dilation and curettage was successfully accomplished in all patients of both groups. Hysterectomy was not needed in all patients. Statistically significant differences in the recovered time of HCG level, occurrence of complications and the twice treatment rate existed between the two groups (P0.05). The exogenous type of cesarean scar pregnancy in group A and group B was proved in 15 cases and 11 cases respectively, and the success rate of treatment for them was 86.7%(13/15) and 45.5%(5/11) respectively (P<0.05). The differences in postoperative vaginal bleeding time, the menstrual recovery time, the recovered time of HCG level, the twice treatment rate and the success rate of treatment between the two exogenous type subgroups were statistically significant (P<0.05 in all). Conclusion For the treatment of cesarean scar pregnancy, both UAE and UACE with subsequent curettage are safe and effective. For the treatment of endogenous type of CSP, it is better to use UAE, while for the treatment of exogenous type of CSP, it is better to use UACE.