Department of Obstetrics and Gynecology, Affliated Hospital of Guilin Medical University, Guilin, 541000, Guangxi, People's Republic of China.
Department of Ultrasound, Affliated Hospital of Guilin Medical University, Guilin, 541000, Guangxi, People's Republic of China.
BMC Pregnancy Childbirth. 2019 Aug 27;19(1):312. doi: 10.1186/s12884-019-2468-3.
This study aims to evaluate the curative effect and complications in cesarean scar pregnancy (CSP) patients treated with a transvaginal injection of absolute ethanol (AE) around the gestation sac (GS) under ultrasound guidance.
This retrospective clinical investigation analyzed 26 CSP patients treated at the Affiliated Hospital of Guilin Medical University in Guilin, Guangxi, China, between January 1, 2018 and January 30, 2019. Outcomes and complications were analyzed following treatment with AE.
Out of the entire group, 20 patients were successfully treated with a single AE injection, while the remaining six patients required two or three repeat injections. In 21 patients, the serum beta-human chorionic gonadotropin (β-hCG) level was reduced to > 50% 1 day after a single AE injection; in 19 patients, the serum β-hCG level was reduced to > 80% 4 days after a single AE injection. In all patients, the average time for serum β-hCG to reduce to normal levels (< 3.0 mIU/mL) was 36.50 ± 12.54 days. The overall cure rate of CSP by AE injection was 100%. Average length of hospitalization was 6.73 ± 3.66 days, with Patient 2 having the longest hospitalization at 17 days, and Patient 3 the shortest at 2 days. No adverse effects on hematopoietic, hepatic or renal function were observed in the short term.
The study demonstrated that transvaginal injection of AE around the gestation sac under ultrasound guidance had good clinical effects, fewer complications, and merit as a novel treatment for CSP. However, larger multi-center trials are needed to confirm the safety and effectiveness of this treatment.
本研究旨在评估超声引导下经阴道妊娠囊（GS）周围注射无水乙醇（AE）治疗剖宫产瘢痕妊娠（CSP）患者的疗效和并发症。
本回顾性临床研究分析了 2018 年 1 月 1 日至 2019 年 1 月 30 日在桂林医学院附属医院治疗的 26 例 CSP 患者。分析 AE 治疗后的结局和并发症。
整个组中，20 例患者单次 AE 注射治疗成功，而其余 6 例患者需要 2 或 3 次重复注射。21 例患者单次 AE 注射后 1 天血清β-人绒毛膜促性腺激素（β-hCG）水平下降>50%；19 例患者在单次 AE 注射后 4 天血清β-hCG 水平下降>80%。所有患者血清β-hCG 降至正常水平（<3.0 mIU/mL）的平均时间为 36.50±12.54 天。AE 注射治疗 CSP 的总治愈率为 100%。平均住院时间为 6.73±3.66 天，2 号患者住院时间最长为 17 天，3 号患者最短为 2 天。短期内未观察到对造血、肝肾功能的不良影响。
本研究表明，超声引导下经阴道妊娠囊周围注射 AE 治疗 CSP 具有良好的临床效果，并发症少，是治疗 CSP 的一种新方法。然而，需要更大规模的多中心试验来证实这种治疗方法的安全性和有效性。
