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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (3): 555-560    DOI: 10.31083/j.ceog.2021.03.2356
Original Research Previous articles | Next articles
Surgical management for type II cesarean scar pregnancy
Lin Ling1, Juanjuan Fu1, Lei Zhan1, Wenyan Wang1, Qian Su1, Jun Li1, Bing Wei1, *()
1Department of Gynaecology and Obstetrics, the Second Affiliated Hospital of Anhui Medical University, 230601 Hefei, Anhui, China
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Abstract  
Background: Cesarean scar pregnancy (CSP), a rare type of ectopic pregnancy, can lead to adverse pregnancy outcomes. However, there is no uniform international treatment guideline for CSP. In this study, we retrospectively analyzed the advantages and disadvantages of three different surgical methods for type II CSP, trying to find the best treatment plan. Methods: From January 2013 to December 2018, a retrospective analysis was performed in 58 patients with type II CSP admitted to the Department of Gynecology, Second Affiliated Hospital of Anhui Medical University. 20 patients underwent hysteroscopic resection (Group A), 18 patients underwent laparoscopic resection and repair (Group B), and 20 patients underwent vaginal resection and repair (Group C). All patients were treated with preventive uterine artery embolization (UAE) preoperatively. The clinical data were collected, and the treatment effects of the different surgical methods were compared. Results: Age, gravidity, parity, number of previous cesarean sections, time period since the last cesarean section, menolipsis days, and preoperative level of the beta-subunit of human chorionic gonadotropin (β-hCG) were not significant different among the three groups (P > 0.05). The differences in operation time (46.85 ± 20.91 min vs. 105.78 ± 32.95 min vs. 67.85 ± 32.88 min), intraoperative blood loss (45.00 ± 17.32 mL vs. 262.22 ± 235.74 mL vs. 166.50 ± 150.66 mL), postoperative hemoglobin level decreased (11.60 ± 5.60 g/L vs. 20.11 ± 7.72 g/L vs. 14.95 ± 5.40 g/L), and menstrual cycle recovery time (35.40 ± 6.31 day vs. 30.11 ± 5.04 day vs. 30.80 ± 4.62 day) were significant different. Conclusions: Hysteroscopic, laparoscopic, and transvaginal surgery can effectively treat type II CSP. Treatment should be individualized according to the diameter of the gestational sac, the patient's fertility requirements as well as the doctor's surgical experience and the surgical equipment of the local hospital.
Key words:  Cesarean scar pregnancy (CSP)      Hysteroscopic surgery      Laparoscopic surgery      Transvaginal surgery     
Submitted:  12 November 2020      Revised:  27 January 2021      Accepted:  03 February 2021      Published:  15 June 2021     
Fund: 
2019xkt040/Anhui Medical University
*Corresponding Author(s):  Bing Wei     E-mail:  happyforever_00@163.com

Cite this article: 

Lin Ling, Juanjuan Fu, Lei Zhan, Wenyan Wang, Qian Su, Jun Li, Bing Wei. Surgical management for type II cesarean scar pregnancy. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(3): 555-560.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.03.2356     OR     https://ceog.imrpress.com/EN/Y2021/V48/I3/555

[1] Jun Xiong, Fen Fu, Wei Zhang, Ji Luo, Yuan-Yuan Xu, Lu-Lu Le, Xiao-Ju He. Study on influencing factors and related clinical issues in cesarean scar pregnancy[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(2): 365-371.
[2] L.B. Liu, H.T. Sun, S.F. Liu, R.X. Shi. Laparoscopy combined with hysteroscopy for cesarean scar pregnancy[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(6): 911-914.
[3] F.Q. Sun, T. Wang, X.H. Xu, C. Han, J. Jin. Rare case of bizarre leiomyoma in Mayer-Rokitansky-Küster-Hauser Syndrome[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 434-437.
[4] K. Nakamura, K. Nakayama, T. Minamoto, T. Ishibashi, K. Sanuki, H. Yamashita, R. Ono, H. Sasamori, S. Razia, M.M. Hossain, S. Kamrunnahar, M. Ishikawa, S. Kyo. A novel retrograde approach for total laparoscopic hysterectomy in patients with severe adhesion in the cul-de-sac[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(4): 565-569.
[5] Munetoshi Akazawa, Yuzo Imachi, Kiyoshi Aiko, Kazushige Nakahara, Sachiko Onjo. Carcinoma of unknown primary site and ectopic pregnancy diagnosed at laparoscopic surgery: a rare coexistence[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(4): 626-628.
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