Vo Tuan Minh, Dinh Hoang T, Van Thong P, Nguyen Christopher Son
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at HCMC, Vietnam.
Department of Gynecology, Tudu Hospital at Ho Chi Minh City, Vietnam.
Gynecol Minim Invasive Ther. 2021 Apr 30;10(2):84-90. doi: 10.4103/GMIT.GMIT_127_19. eCollection 2021 Apr-Jun.
An earlier study completed at TuDu Hospital presented the efficacy of Foley insertion combined with fetal suction curettage at a high rate of success in treatment of cesarean scar pregnancy (CSP) of < 8 weeks, but the efficacy of prognosticating factors for this approach has not been specifically addressed yet, especially crossover sign (COS) on ultrasound. We aimed to investigate the correlation between COS on ultrasound and the treatment results of CSP using Foley insertion combined with fetal suction.
A case-control study of CSPs ≤ 8 weeks treated at TuDu Hospital during September 2017-April 2019 included 63 failures in the case group and 98 successes in the control group.
COS-2 + increased the likelihood of treatment success by 4.9 times (95% confidence interval: 1.8-13.5) compared with COS-1 cases. In addition, other factors favoring treatment success with statistical significance included no vascularization at cesarean scar on ultrasound (odds ratio [OR] = 7.1), gestational mass volume ≤4 cm (OR = 3.7), and β-human chorionic gonadotropin at hospital admission ≤ 10,000 mIU/mL (OR = 6.1).
COS imaging played an important role in the prediction of treatment outcomes for CSP ≤ 8 weeks by the combined approach of Foley insertion and fetal suction curettage.
都都医院之前完成的一项研究表明，在治疗孕周<8周的剖宫产瘢痕妊娠（CSP）时， Foley导管置入联合刮宫术成功率较高，但该方法的预后因素疗效尚未得到具体研究，尤其是超声检查中的交叉征（COS）。我们旨在研究超声检查中的COS与采用Foley导管置入联合刮宫术治疗CSP的结果之间的相关性。
对2017年9月至2019年4月在都都医院接受治疗的孕周≤8周的CSP患者进行病例对照研究，病例组6336例失败，对照组98例成功。
与COS-1病例相比，COS-2+使治疗成功的可能性增加了4.9倍（95%置信区间：1.8-13.5）。此外，其他有利于治疗成功且具有统计学意义的因素包括超声检查显示剖宫产瘢痕处无血管化（比值比[OR]=7.1）、妊娠包块体积≤4 cm（OR=3.7）以及入院时β-人绒毛膜促性腺激素≤10,000 mIU/mL（OR=6.1）。
COS成像在预测孕周≤8周的CSP采用Foley导管置入联合刮宫术的治疗结果中发挥了重要作用。
