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| The application value of uterine arterial embolization combined with methotrexate for treating induced abortion women with high risk factors |
| Huanggang Central Hospital, Huanggang, Hubei Province |
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Abstract Objective:To investigate the effectiveness of uterine artery embolization combined with methotrexate intervention for treating induced abortion women with high risk factors. Methods: 78 induced abortion patients with scar pregnancy from Jan 2014 to May 2017 were selected as the study subject, and all of the women were divided into control group or observation group (39 patients in each group) by random digital table. The women in control group had received uterine artery embolization combined with curettage of uterine cavity, and women in observation group had received methotrexate treatment except uterine artery embolization combined with curettage of uterine cavity. The situation during operations and postoperative, the changes of serumβhuman chorionic gonadotropin (β-HCG) and progesterone (P) levels, the change of the uterine hemodynamics before and 3 days after operation, and the incidence of complications and the situation of followed up of women in both groups were observed. Results: All women in the two groups were successfully completed the operation, and there was no case with profuse bleeding or hysterectomy. The valume of intraoperative blood loss, the postoperative hospital stay time, the valume of postoperative blood loss, time of β-HCG recovery, and the time of menstrual recovery of women in observation group were significant better than those of women in control group (P<0.05), but there was no significant difference in operation time between the two groups (P>0.05). There were no significant different in serum β-HCG and P levels of women between the two groups before operation (P>0.05), but 3 days after operation, the serum β-HCG and P levels of women in observation group were significant lower than those of women in control group (P<0.05). There were no significant different in the uterine hemodynamics of women between the two groups before operation (P>0.05), but 3 days after operation, the value of resistance index (RI) and pulsation index (PI) of women in observation group were significant smaller than those of women in control group (P<0.05). The incidence of postoperative complications of women in observation group was 7.7%, which was significant lower than that of women (25.6%) in control group (P<0.05). When the last time followed up, the rates of tubal patency, recurrent intrauterine pregnancy, and ectopic pregnancy of women in observation group were 84.6%, 46.2% and 0.0%, respectively, which were statistically significant different to those of women (64.10%, 23.08%, and 10.26%, respectively) in control group (P<0.05). Conclusion: Uterine arterial embolization combined with methotrexate for treating induced abortion women with high risk factors can effectively reduce intraoperative bleeding, can promote postoperative recovery, can reduce the risk of complications, and can improve the long-term prognosis.
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