Department of Obstetrics and Gynecology, Chaoyang Central Hospital, Chaoyang, Liaoning Province, China.
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
Int J Gynaecol Obstet. 2022 Mar;156(3):488-493. doi: 10.1002/ijgo.13682. Epub 2021 Apr 13.
To study indicators predicting the safety of hysteroscopic management for cesarean scar pregnancy (CSP) patients.
This was a retrospective study, starting from June 1, 2020. The study included 141 CSP patients who underwent hysteroscopic surgery and met the requirements of gestational age ≤12 weeks, stable vital signs, and preoperative magnetic resonance imaging. Patients were divided into control group and testing group according to surgical outcomes. Preoperative indicators were compared between the two groups, including a novel indicator, cesarean section diverticulum (CSD) area.
Univariate analysis identified five statistically significant (P < 0.05) factors associated with hysteroscopy failure including a large CSD area. Multifactor logistic regression analysis showed that the only statistically significant indicator of all five factors was the CSD area. The area under the receiver operating characteristics curve of CSD area was 0.848. Next, we determined three cut-off values for CSD area that can be used to predict the outcome of surgery: 138, 189, and 300 mm .
For the first time, we found that CSD area could predict the safety of hysteroscopic management for CSP patients and might be helpful for clinical decision making. The findings need to be verified by further research.
研究预测剖宫产憩室妊娠（CSP）患者宫腔镜管理安全性的指标。
这是一项回顾性研究，从 2020 年 6 月 1 日开始。本研究纳入了 141 例接受宫腔镜手术且符合妊娠年龄≤12 周、生命体征稳定和术前磁共振成像要求的 CSP 患者。根据手术结果，将患者分为对照组和测试组。比较两组患者的术前指标，包括一个新的指标剖宫产憩室（CSD）面积。
单因素分析确定了 5 个与宫腔镜失败相关的统计学显著（P<0.05）因素，包括较大的 CSD 面积。多因素逻辑回归分析显示，所有 5 个因素中唯一具有统计学意义的指标是 CSD 面积。CSD 面积的受试者工作特征曲线下面积为 0.848。接下来，我们确定了 CSD 面积的三个截断值，可用于预测手术结果：138、189 和 300mm。
我们首次发现 CSD 面积可以预测 CSP 患者宫腔镜管理的安全性，可能有助于临床决策。这一发现需要进一步研究加以验证。
