The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study
Abstract Background Cesarean scar pregnancy (CSP) is a long-term complication of cesarean section characterized by the localization of a subsequent gestational sac within the scar area or niche developed as a result of a previous cesarean section. Its incidence has increased substantially because of...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-024-06344-y |
| _version_ | 1797272921198034944 |
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| author | Xinxin You Yan Ruan Shouxiang Weng Chenya Lin Meifu Gan Feng Qi |
| author_facet | Xinxin You Yan Ruan Shouxiang Weng Chenya Lin Meifu Gan Feng Qi |
| author_sort | Xinxin You |
| collection | DOAJ |
| description | Abstract Background Cesarean scar pregnancy (CSP) is a long-term complication of cesarean section characterized by the localization of a subsequent gestational sac within the scar area or niche developed as a result of a previous cesarean section. Its incidence has increased substantially because of the high global cesarean section rate in recent decades. Several surgical and drug treatments exist for this condition; however, there is currently no optimal treatment. This study compared the effectiveness of direct hysteroscopic removal of the gestational tissue and hysteroscopy combined with vacuum suction for the treatment of CSP. Methods From 2017 to 2023, 521 patients were diagnosed with CSP at our hospital. Of these patients, 45 underwent hysteroscopy. Among them, 28 underwent direct hysteroscopic removal (hysteroscopic removal group) and 17 underwent hysteroscopy combined with vacuum suction (hysteroscopic suction group). The clinical characteristics and outcomes of the hysteroscopic removal group and hysteroscopic suction group were analyzed. Results Among the 45 patients, the amount of bleeding and hospitalization cost were significantly higher in the hysteroscopic removal group than in the hysteroscopic suction group (33.8 mL vs. 9.9 mL, P < 0.001; and 8744.0 yuan vs. 5473.8 yuan, P < 0.001; respectively). The operation time and duration of hospitalization were significantly longer in the hysteroscopic removal group than in the hysteroscopic suction group (61.4 min vs. 28.2 min, P < 0.001; and 3.8 days vs. 2.4 days, P = 0.026; respectively). Three patients in the hysteroscopic removal group had uterine perforation and received laparoscopic repair during operation. No complications occurred in the hysteroscopic suction group. One patient in the hysteroscopic removal group received ultrasound-guided suction curettage due to postoperative moderate vaginal bleeding, and one patient in the hysteroscopic suction group received ultrasound-guided suction curettage due to postoperative gestational residue and elevated serum beta-human chorionic gonadotropin levels. Reproductive function was preserved in all patients. Conclusions Hysteroscopy is an effective method for treating CSP. Compared with direct hysteroscopic removal, hysteroscopy combined with vacuum suction is more suitable for CSP. However, multicenter prospective studies with large sample sizes are required for verification of these findings. |
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| format | Article |
| id | doaj.art-c618e0953afa43379cfd2c3c130286a3 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-07T14:36:13Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-c618e0953afa43379cfd2c3c130286a32024-03-05T20:39:44ZengBMCBMC Pregnancy and Childbirth1471-23932024-02-012411710.1186/s12884-024-06344-yThe effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort studyXinxin You0Yan Ruan1Shouxiang Weng2Chenya Lin3Meifu Gan4Feng Qi5Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang UniversityDepartment of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang UniversityDepartment of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang UniversityDepartment of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang UniversityDepartment of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang UniversityDepartment of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Zhejiang UniversityAbstract Background Cesarean scar pregnancy (CSP) is a long-term complication of cesarean section characterized by the localization of a subsequent gestational sac within the scar area or niche developed as a result of a previous cesarean section. Its incidence has increased substantially because of the high global cesarean section rate in recent decades. Several surgical and drug treatments exist for this condition; however, there is currently no optimal treatment. This study compared the effectiveness of direct hysteroscopic removal of the gestational tissue and hysteroscopy combined with vacuum suction for the treatment of CSP. Methods From 2017 to 2023, 521 patients were diagnosed with CSP at our hospital. Of these patients, 45 underwent hysteroscopy. Among them, 28 underwent direct hysteroscopic removal (hysteroscopic removal group) and 17 underwent hysteroscopy combined with vacuum suction (hysteroscopic suction group). The clinical characteristics and outcomes of the hysteroscopic removal group and hysteroscopic suction group were analyzed. Results Among the 45 patients, the amount of bleeding and hospitalization cost were significantly higher in the hysteroscopic removal group than in the hysteroscopic suction group (33.8 mL vs. 9.9 mL, P < 0.001; and 8744.0 yuan vs. 5473.8 yuan, P < 0.001; respectively). The operation time and duration of hospitalization were significantly longer in the hysteroscopic removal group than in the hysteroscopic suction group (61.4 min vs. 28.2 min, P < 0.001; and 3.8 days vs. 2.4 days, P = 0.026; respectively). Three patients in the hysteroscopic removal group had uterine perforation and received laparoscopic repair during operation. No complications occurred in the hysteroscopic suction group. One patient in the hysteroscopic removal group received ultrasound-guided suction curettage due to postoperative moderate vaginal bleeding, and one patient in the hysteroscopic suction group received ultrasound-guided suction curettage due to postoperative gestational residue and elevated serum beta-human chorionic gonadotropin levels. Reproductive function was preserved in all patients. Conclusions Hysteroscopy is an effective method for treating CSP. Compared with direct hysteroscopic removal, hysteroscopy combined with vacuum suction is more suitable for CSP. However, multicenter prospective studies with large sample sizes are required for verification of these findings.https://doi.org/10.1186/s12884-024-06344-yCesarean scar pregnancyHysteroscopyDirect gestational tissue removalVacuum suctionSerum β-hCG |
| spellingShingle | Xinxin You Yan Ruan Shouxiang Weng Chenya Lin Meifu Gan Feng Qi The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study BMC Pregnancy and Childbirth Cesarean scar pregnancy Hysteroscopy Direct gestational tissue removal Vacuum suction Serum β-hCG |
| title | The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study |
| title_full | The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study |
| title_fullStr | The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study |
| title_full_unstemmed | The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study |
| title_short | The effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy: a retrospective cohort study |
| title_sort | effectiveness of hysteroscopy for the treatment of cesarean scar pregnancy a retrospective cohort study |
| topic | Cesarean scar pregnancy Hysteroscopy Direct gestational tissue removal Vacuum suction Serum β-hCG |
| url | https://doi.org/10.1186/s12884-024-06344-y |
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