title: Transvaginal surgical management of cesarean scar pregnancy: analysis of 49 cases from one tertiary care center.
abstract: OBJECTIVE
  To investigate the safety and effectiveness of transvaginal surgical management of cesarean scar pregnancy (CSP).
  
  
  METHODS
  Retrospective analysis of 49 CSP patients who received transvaginal surgery in our hospital between December 2009 and April 2013. Patients were divided into two groups. Group A (30 patients) was defined as patients who had not received any treatment before transvaginal surgical management. Group B (19 patients) referred to patients who had received any previous treatment. Preoperative, intraoperative and postoperative data of both groups were collected and analyzed retrospectively.
  
  
  RESULTS
  Preoperative serum β-hCG level, preoperative hemoglobin level and average serum β-hCG resolution time of group A and group B were 53,458.50 (36,382.00-94,100.50) versus 9779.00 (932.50-29623.00)U/l, 123.87±10.95 versus 109.94±16.05 g/l and 3.55±1.81 versus 1.83±1.15 weeks (P<0.05). Vaginal bleeding and gestational age in group A were significantly lower than in group B, 2.5 (0.50-11.00) versus 15.00 (3.50-31.50) days and 52.50 (46.50-56.70) versus 60.00 (48.00-90.00) days, respectively (P<0.05). The operative time, estimated blood loss, postoperative hospital stay, hospitalization expenses and menstruation recovery time of group A and group B were 56.61±24.40 versus 67.56±43.52 min, 45.65±27.83 versus 76.67±50.87 ml, 5.10±2.89 versus 5.33±3.99 days, 9001.94±1848.37 versus 11,032.33±5534.14 RMB and 1.16±0.47 versus 1.26±0.63 month respectively, which were similar between the two groups (P>0.05). The intraoperative complication rate in group A was significantly lower than group B, 0 (0/30) versus 21.05% (4/19) (P<0.05). The postoperative complication rate and total complication rate in group A and group B were 10.00% (3/30) versus 21.05% (4/19) and 10.00% (3/30) versus 31.58% (6/19) (P>0.05), respectively.
  
  
  CONCLUSIONS
  Transvaginal surgery is an effective and relatively safe treatment option for CSP patients.
authors.affiliation: Department of Gynecology and Obstetrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
authors.forename: Jin-Bo
authors.initials: JB
authors.lastname: Li
authors.affiliation: Department of Gynecology and Obstetrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
authors.forename: Ling-Zhi
authors.initials: LZ
authors.lastname: Kong
authors.affiliation: Department of Gynecology and Obstetrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
authors.forename: Li
authors.initials: L
authors.lastname: Fan
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Fu
authors.affiliation: Department of Gynecology and Obstetrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China. Electronic address: chenshuqin1021@163.com.
authors.forename: Shu-Qin
authors.initials: SQ
authors.lastname: Chen
authors.affiliation: Department of Gynecology and Obstetrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
authors.forename: Shu-Zhong
authors.initials: SZ
authors.lastname: Yao
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D002585:Cesarean Section / Q000009:adverse effects*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D002921:Cicatrix / Q000150:complications*; D005260:Female; D005865:Gestational Age; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008598:Menstruation; D061646:Operative Time; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000209:etiology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery; D014621:Vagina
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D006454:Hemoglobins
keywords: Cesarean scar pregnancy; Pregnancy outcome; Transvaginal surgery