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| Influences of transvaginal type III cesarean scar pregnancy removal of patients on their stress response and reproductive function |
| Affiliated Hospital of Henan Medical College, The Second People's Hospital of Henan Province, Zhengzhou, Henan Province, 450000 |
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Abstract To observe the influence of transvaginal type III cesarean scar pregnancy (CSP) removal of patients on their stress response and reproductive function. Methods: A total of 50 patients with type III CSP from January 2019 to June 2021 were collected retrospectively and were divided into two groups according to diffrent treatment methods. 24 patients in group A were treated with methotrexate (MTX) combined curettage and evacuation monitored by ultrasound, and 26 patients in group B were treated with transvaginal curettage and evacuation. The operation status, the stress response, the levels of sex hormone, and the rates of complications, normal pregnancy, and recurrence of CSP during 1-year of follow-up of the patients were compared between the two groups. Results: The intraoperative blood loss (95.1±8.2 ml) of the patients in group B was significantly less than that (186.7±49.1 ml) of the patients in group A, and the time of the level of blood β-hCG return to normal (20.0±2.4d) of the patients in group B was significantly shorter than that (36.0±5.8d) of the patients in group A. The time of operation (43.9±8.5min) of the patients in group B was significantly longer than that (32.1±3.7min) of the patients in group A, and the hospital stay time (9.1±2.6d) of the patients in group B was significantly shorter than that (14.9±2.4d) of the patients in group A. The levels of cortisol (Cor) and norepinephrine (NE) of the patients in both groups at 24h after surgery had increased significantly, but which of the patients in group B were significantly lower than those of the patients in group A. The level of testosterone (T) of the patients in both groups after surgery had decreased significantly, and the levels of follicle stimulating hormone, luteinizing hormone, and estradiol of the patients in both groups had increased significantly after surgery, but the change range of which of the patients in group B were significantly more than those of the patients in group A (all P<0.05). The complication rate (7.7%) of the patients in group B was significantly lower than that (37.5%) of the patients in group A, the normal pregnancy rate (34.6%) of the patients in group B was significantly higher than that (8.3%) of the patients in group A, and the recurrence rate (3.9%) of the patients in group B was significantly lower than that (25.0%) of the patients in group A (all P<0.05). Conclusion: Although the operation time of transvaginal curettage and evacuation for treating III type CSP is slightly longer, it has the characteristics of less intraoperative blood loss, shorter time of blood β-hCG return to normal, light stress reaction, fewer complications rate, high rate of normal pregnancy, and low recurrence rate of CSP after 1 year of follow-up, which is conducive to the preservation of reproductive function and early discharge from hospital of these patients.
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