School of Medical and Life Sciences,Chengdu University of Traditional Chinese Medicine, 37 Twelfth Bridge Road, Chengdu, 610072, Sichuan, China.
Chengdu Hospital for Reproduction, Women and Children, Chengdu University of Chinese Medicine, Sichuan, Chengdu, China.
BMC Pregnancy Childbirth. 2022 Jul 30;22(1):607. doi: 10.1186/s12884-022-04848-z.
To investigate the safety and feasibility of high intensity focused ultrasound (HIFU) ablation followed by ultrasound-guided dilation and curettage (USg-D&C) for two types patients with cesarean scar pregnancy (CSP-I and CSP-II).
This study was a retrospective analysis of 101 CSP-I patients and 52 CSP-II patients who received HIFU ablation followed by USg-D&C from Jun 2014 to Oct 2020. The diameter of gestational sac/mass, thickness of the intervening myometrium, intraoperative blood loss, operation time, length of hospital stays, adverse effects and β-HCG level in the two groups were compared.
All patients successfully received HIFU ablation under conscious sedation. The median total treatment time of HIFU ablation and median USg-D&C time in the CSP-I group were statistically longer than those in the CSP-II group (P < 0.05). The average intraoperative median blood loss was 39 ml in the CSP-I group and 65 ml in the CSP-II group (P < 0.05). The duration of hospitalization was 7.07 ± 1.83 days in the CSP-I group and 7.18 ± 1.72 days in the CSP-II group (P > 0.05). The average time needed for β-HCG return to normal levels was 26.08 ± 5.02. and 28.15 ± 4.99 days for CSP-I and CSP-II, respectively (P > 0.05). The percentage of adverse effects and complications was not significantly different between the two groups (P > 0.05).
HIFU ablation followed by USg-D&C was safe and effective in treating the CSP-I patients and CSP-II patients, which may be a potential noninvasive therapeutic option for patients with CSP.
探讨高强度聚焦超声（HIFU）消融联合超声引导清宫术（USg-D&C）治疗两种类型剖宫产瘢痕妊娠（CSP-I 和 CSP-II）患者的安全性和可行性。
本研究回顾性分析了 2014 年 6 月至 2020 年 10 月期间 101 例 CSP-I 患者和 52 例 CSP-II 患者，均接受 HIFU 消融联合 USg-D&C 治疗。比较两组患者的妊娠囊/肿块直径、间隔肌厚度、术中出血量、手术时间、住院时间、不良反应及β-HCG 水平。
所有患者均在清醒镇静下成功接受 HIFU 消融。CSP-I 组 HIFU 消融和 USg-D&C 的中位总治疗时间明显长于 CSP-II 组（P < 0.05）。CSP-I 组术中平均中位出血量为 39ml，CSP-II 组为 65ml（P < 0.05）。CSP-I 组的住院时间为 7.07 ± 1.83 天，CSP-II 组为 7.18 ± 1.72 天（P > 0.05）。两组患者β-HCG 恢复正常水平的平均时间分别为 26.08 ± 5.02 天和 28.15 ± 4.99 天（P > 0.05）。两组不良反应和并发症发生率无统计学差异（P > 0.05）。
HIFU 消融联合 USg-D&C 治疗 CSP-I 患者和 CSP-II 患者安全有效，可能是 CSP 患者一种有潜力的非侵入性治疗选择。
