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| Effect of transvaginal cesarean scar pregnancy debridement surgery and its impact on the menstrual recovery |
| Jiaxing Second Hospital, Zhejiang Province, 314000 |
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Abstract To explore the effect of transvaginal cesarean scar pregnancy debridement surgery (TCSPDS) for treating patients with cesarean scar pregnancy (CSP), and to study its impact on the menstrual recovery of the patients. Methods: The clinical data of 53 patients with CSP diagnosed and treated in hospital from January 2020 to August 2022 were analyzed retrospectively. According to the different treatment methods, these patients were divided into control group (22 patients with treatment of uterine artery embolization (UAE) combined with curettage) and study group (31 patients with treatment of TCSPDS). The operation index, the curative effect, the postoperative recovery, the complication rate, and the quality of life of the patients were compared between the two groups. Results: The operation time (43.8±9.4 min) of the patients in the study group was significantly longer than that (26.3±5.2 min) of the patients in the control group, and the intraoperative blood loss (64.5±11.6 ml) of the patients in the study group was significantly more than that (35.5±9.7 ml) of the patients in the control group. The postoperative hospital stay (6.7±1.8 d) of the patients in the study group was significantly shorter than that (9.3±2.6 d) of the patients in the control group (P＜0.05). The rates of treatment effectiveness (96.8%) and total postoperative complications (6.5%) of the patients in the study group had no significantly different from those (90.9% and 18.2%) of the patients in the control group (P＞0.05). The rate of postoperative prolonged menstruation (0) of the patients in the study group was significantly lower than that (27.3%) of the patients in the control group. The time of vaginal bleeding (9.5±2.4 d), the time of menstrual recovery (31.9±8.6 d), the time of blood HCG turn to normal (17.4±5.0 d) of the patients in the study group were significantly shorter than those (12.2±3.2 d, 43.5±11.8 d, and 25.8±7.1 d) of the patients in the control group (P＜0.05). The quality of life score (64.02±8.28 points) of the patients in the study group in 3 months after operation was significantly lower than that (69.09 ±9.12 points) of the patients in the control group. The quality of life score (69.23±8.71 points) of the patients in the study group in 6 months after operation was significantly higher than that in 3 months after operation. The quality of life score (69.57±8.24 points) of the patients in the control group in 6 months after operation had no significantly different from that in 3 months after operation, and which of the patients in 6 months after operation had no significant difference between the two groups (P＞0.05). Conclusion: TCSPDS for treating the patients with CSP has the similar efficacy and safety to those of UAE combined with curettage, but which can improve the menstrual recovery and the blood HCG return to normal of the patients rapidly, can shorten the hospital stay of the patients, and can prevent the occurrence of prolonged menstrual period after operation. However, TCSPDS is insufficient in improving the quality of life of the patients at early stage comparing with those of UAE combined with curettage.
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