Management of Caesarean Scar Pregnancy by Hysteroscopy Combined with Foley Balloon Tamponade / 中国微创外科杂志

ABSTRACT

Objective To investigate the clinical effect of hysteroscopy combined with foley balloon tamponade in the management of caesarean scar pregnancy ( CSP ) . Methods Twenty-one cases were diagnosed as having CSP by ultrasound examinations from January 2008 to November 2013.Among them, 11 cases with serum β-hCG below 500 IU/L underwent the surgery after taking mifepristone for 2 days, while 10 cases with serum β-hCG over 500 IU/L underwent surgery after injection of MTX combined with oral administration of mifepristone for 7 -14 days.All the cases were treated by hysteroscopy combined with foley balloon tamponade . Results The hysteroscopic operation was successfully conducted in 19 of 21 cases, with the operate time ranged 15-42 min.One case was given a second hysteroscopy and one case required a secondary laparoscopic procedure for the uterine perforation.In 18 cases with preoperative serum β-hCG below 500 IU/L, the intraoperative blood loss was 20 -100 ml, while in another 3 cases with preoperative serum β-hCG 1085-2760 IU/L, the blood loss was 200-800 ml.Follow-up examinations at clinic for 2-4 weeks in 16 cases showed levels of β-hCG declined to normal and recovery of menstruation at 43-56 postoperative days with normal menses amount . Conclusion Hysteroscopy combined with foley balloon tamponade in the management of CSP offers advantages of safety and effectiveness , which is deserved to clinical application .