Effect of combining uterine artery chemoembolization with curettage in treatment of caesarean scar pregnancy and influence factors / 实用放射学杂志

ABSTRACT

Objective To evaluate the effect of combination of uterine artery chemoembolization and curettage in treatment of caesarean scar pregnancy(CSP),and to analyze the possible influence factors.Methods 46 cases with caesarean scar pregnancy treated by the combination of uterine artery chemoembolization and curettage were retrospectively analyzed.Univariate analysis was made on the factors that might influence the efficacy,and the Logistic regression model was constructed for the significant variables.Results All of the patients were terminated pregnancy succesfully .According to the ultrasound recheck,there were no residual gestational sac tissue in 29 patients,and some residual gestational sac tissue in 17 patients.After the application of traditional Chinese medicine or methotrexate and other symptomatic treatment, the pregnancy was terminated.The univariate analysis showed that the number of cesarean section,the gestational sac volume,the gestational weeks,the type of CSP,and the condition of the fetal heart pulsation were related to the presence of residues in the uterus after treatment (P＜0.05).The multivariate analysis showed that gestational sac volume ＞9 cm3 ,gestational weeks ＞ 7 weeks and exogenous CSP were the independent factors leading to intrauterine residual gestational sac tissue.Conclusion Uterine artery chemoembolization combined with curettage is an effective method for treatment of caesarean scar pregnancy.It is proposed that clinical treatment should pay close attention to the factors that may affect the efficacy.