Comparison of HIFU and UAE pretreatment methods before suction curettage in cesarean scar pregnancy
CHEN Xiao1, XU Ye2, YANG Zhenhua1, SUN Chaoying1, ZHANG Yan1
1. Department of Obstetrics and Gynecology,Featured Medical Center of the Chinese People's Armed Force,Tianjin 300162,China; 2. Logistics Department Health Bureau of Chinese People's Armed Police Force, Beijing 100089, China
Abstract：Objective To compare the difference between high intensity focused ultrasound (HIFU) and uterine artery embolization before suction curettage in cesarean scar pregnancy (CSP).Methods The clinical data on77 cases of CSP treated in the Department of Obstetrics and Gynecology of Featured Medical Center of the Chinese People's Armed Force between January 2013 and October 2018 was retrospectively analyzed. Based on the different pretreatment methods before suction curettage, the patients were randomly divided into two groups: one group treated with HIFU, and the other group receiving uterine artery perfusion embolization. Curettage was conducted 2 or 3 days after treatment. The gestational age, number of times of cesarean section, time interval from the previous cesarean section, estationalduration, average diameter of the gestational sac, thickness of the myometrium in the scar of uterus, duration of surgery, amount of intraoperative bleeding, length of hospital stay, cost of hospitalization, number of cases converted to laparotomy during suction curettage, the mode of operation and CSP classification were observed and analyzed.Results There were 2 cases of intraoperative bleeding that exceeded 50 ml in HIFU group (5.41%), compared with 6 cases in uterine artery embolization group (17.14%). Five patients with CSPIII, including 2 in HIFU group and 3 in uterine artery embolization group, were converted to laparotomy because of bleeding during uterine curettage. The duration of uterine curettage, length of hospital stay and cost of hospitalization in HIFU group were significantly shorter or lower than those in uterine artery embolization group (P<0.05).Conclusions The management of CSP by HIFU combined with suction curettage is safe and effective.
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2020, Vol. 31 
