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Long-term Complications after Cesarean Section-Diagnosis and Treatment of Cesarean Scar Pregnancy

Author: YuJing
Tutor: WangLiQun
School: Nanchang University
Course: Obstetrics and Gynaecology
Keywords: cesarean scar pregnancy(CSP) misdiagnosis methotrexate(MTX) Uterine artery embolization treatment prognosis
CLC: R714.2
Type: Master's thesis
Year: 2012
Downloads: 95
Quote: 0
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Abstract


Objective：To study the Incidence trends of cesarean scar pregnancy(CSP), clinicalmanifestations, treatment and prognosis, to explore the value and significance ofvarious preserve fertility therapy in the treatment of incision pregnancy.Methods：1.Analysis of clinical data of our hospital from January2007to2011Decemberof cesarean scar pregnancy. Study the incidence of characteristics and trends.2.Comparison misdiagnosis group (study group) and the initial diagnosisconfirmed group (control group) the clinical data of the two groups of patients,analysis of its treatment and prognosis.3.Random sample of methotrexate (MTX) systemic administration+curettagetreatment group (34cases), Uterine artery embolization+curettage treatment group(46cases), Uterine artery embolization+laparotomy pregnancy debridement treatmentgroup (20cases).To study the value and significance of three to preserve fertilitytreatment in the incision pregnancy treatment.Results:1. The incidence of incision pregnancy increasing year by year, the misdiagnosisrate is as high as53.5%.2. Comparison misdiagnosed group and diagnosis group two indicators ofMenopause days and serum HCG values, the difference was statistically significant(P <0.05). The comparison the number of cases of anemia and blood transfusioncases between the two groups, the difference was statistically significant (P <0.05).However, the prognosis between the two groups by comparison, P>0.05, thedifference was not statistically significant.3. Three groups of treatment success rates were: methotrexate (MTX) systemicadministration+curettage treatment group was67.6%, Uterine artery embolization+curettage treatment group was91.3%, uterine artery embolization+laparotomypregnancy debridement treatment group was95.0%. P <0.05, the difference was statistically significant. Hospital stay and hospitalization costs in the three groupswere compared, the difference was statistically significant (P <0.05).Conclusion1. Cesarean scar pregnancy incidence rate showed an increasing trend, easilymisdiagnosed.2.Cesarean scar pregnancy misdiagnosed underwent abortion, medical abortionand curettage is one of the important reasons to cause CSP bleeding and anemia.3.The CSP treatment should be preferred to preserve fertility treatment. Threekinds of treatment programs of methotrexate (MTX) systemic administration+curettage, Uterine artery embolization+curettage, uterine artery embolization+laparotomy pregnancy debridement, such as used properly can achieve good results.Should be based on the patient’s specific circumstances, Select a reasonabletreatment.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Pathological pregnancy ( abnormal pregnancy )
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