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| Comparison of re-pregnancy outcomes of women with different types of cesarean section scar pregnancy after treatment |
| The First People's Hospital of Xining City, Xining, Qinghai Province, 810000 |
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Abstract To investigate the re-pregnancy outcomes of women with different types of cesarean section scar pregnancy (CSP) after treatment. Methods: 150 women with CSP who had re-pregnancy requirement were selected and all received uterine artery embolization plus hysteroscopic lesion resection from April 30, 2016 to April 30, 2017. These women were divided into 64 women with type I CSP in group A, 56 women with type II CSP in group B, and 30 women with type III CSP in group C according to CSP classification criteria. The surgical effect, postoperative recovery, pregnancy status, and pregnancy outcomes of women were compared among the three groups. Results: The operative time or intraoperative blood loss volume of women in group C was the highest, but that of women in group A was the lowest. The success rate of once operation of women in group C was the lowest, but that of women in group A was the highest (all P＜0.05). There were no significant different in the time of menstruation and hCG level returned to normal among the three groups (P＞0.05). In 24-36 months of followed up, there were 98 women with natural pregnancy in the three groups, and the natural pregnancy rate of women in group A (79.7%) was significant higher than that (69.6%) of women in group B and that (27.6%) of women in group C (P＜0.05). In 113 times of the natural pregnancy, the spontaneous abortion rate of women in group C (50.0%) was significant higher than that (17.8%) of women in group B and that (16.4%) of women in group A (P＜0.05). Multiple factors analysis showed that the protection factors of the postoperative natural pregnancy of women in group C were age<30 years old, and scar muscle layer thickness >3 mm. The risk factor was curettage history (P＜0.05). Conclusion: After treatment, the re-pregnancy rate and spontaneous abortion rate, and pregnancy outcomes of women with type Ⅲ CSP are lower than those of women with type Ⅰ and Ⅱ CSP.
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