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Study on the Effect of Different Treatment Modalities for Type II Caesarean Scar Pregnancy on Ovarian Function Indicators and Recurrence of Caesarean Scar Pregnancy |
ZHANG Yuanyuan, SUN Shuhong, YU Le, et al |
Chengde Maternal and Child Health Hospital, Hebei Chengde 067000, China |
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Abstract Objective: To investigate the effect of different treatment methods on ovarian function indexes and recurrence of CSP in type Ⅱ cesarean scar pregnancy (CSP). Methods: A total of 210 patients with type II CSP admitted to our hospital from February 2018 to January 2021 were selected as the research subjects,and they were divided into 3 groups (70 cases in each) by random number table method.Injection of methotrexate (MTX) combined with hysterectomy (group A),hysteroscopic hysterectomy combined with Foley's balloon compression therapy (group B),and laparoscopy combined with hysteroscopy (group C).The operation time,intraoperative blood loss,hospital stay,menstrual recovery time,and endometrial thickness recovery time were compared among the three groups.All patients were followed up for 12 months,and the hormone indexes estradiol (E2) and follicle-stimulating hormone (FSH) levels,luteinizing hormone (LH),and antral follicle numbers in different time periods after surgery were compared in the three groups,and the incidence of CSP during re-pregnancy was compared among the 3 groups. Results: Intraoperative blood loss,hospital stay,menstrual recovery time,and endometrial thickness recovery time in group B were less than those in groups A and C (P<0.05),and the operation time in groups A and B were shorter than those in group C (P<0.05).There were no significant changes in the levels of hormone indicators E2,FSH,LH and the number of antral follicles in the menstrual cycle in different time periods after surgery in the three groups (P>0.05).Within 12 months of follow-up,the incidence of CSP in group B was significantly lower than that in groups A and C (P<0.05). Conclusion: MTX combined with evacuation,hysteroscopic evacuation combined with Foley's balloon compression therapy and laparoscopy combined with hysteroscopy in the treatment of type Ⅱ CSP will not affect the ovarian function of patients,and in the three treatment methods,the uterine cavity is not affected.Endoscopic hysterectomy combined with Foley's balloon compression therapy can reduce the chance of recurrence of CSP.
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