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| Efficacy comparison between transvaginal ultrasound intervention and intrauterine local injection for treating cesarean scar pregnancy |
| 1.Seventh People's Hospital of Zhengzhou City, Henan, 450000; 2.Xiangyang Central Hospital, Affiliated Hospital Of Hubei University of Arts and Science |
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Abstract Objective:To compare the clinical efficacy of transvaginal ultrasound interventional injection with intramuscular injection of methotrexate for treating cesarean scar pregnancy (CSP). Method: 68 patients with CSP from March 2016 to March 2018 were randomly divided into observation group and control group according random number table (34 cases in each group). The patients in observation group were treated by local transvaginal injection of methotrexate under ultrasound, and patients in control group were treated by a single intramuscular injection of methotrexate. The effect of cure, the serum correlation index, and the rate of adverse reactions of patients were compared between the two groups. Results: In observation group, the amount of hemorrhage, the time of returning to normal HCG, the recovery time of menstruation, and the time of discharge of patients, and the number of needing additional methotrexate in observation group were all significant less than those of patients in control group (P<0.05). After 7 days of treatment, the cure rate of patients in observation group was 97.1%, which was significant higher than that of patients (64.7%) in control group (P<0.05). After patients were given additional medication, the cure rate of patients (100.0%) in observation group was still significant higher than that of patients (79.4%) in control group (P<0.05). There was no significant difference in level of serum PAPP A, VEGF, and INH A, and rate of blood supply between the two groups before treatment (P>0.05), but on the 3 and the 7 day after treatment, the above indexes of patients in observation group were significant lower than those of patients in control group (P<0.05). The incidence of adverse reactions of patients (11.8%) in observation group was significant lower than that of patients (35.3%) in control group (t=15.39, P<0.05). Conclusion: The local injection of methotrexate transvaginal ultrasound for treating CSP has perfect effectiveness, and has less adverse reaction, so it is worthy of clinical application.
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