Curettage or operative hysteroscopy in the treatment of cesarean scar pregnancy.
OBJECTIVE
To compare the clinical effects of dilatation and curettage (D&C) regimen and operative hysteroscopy coupled with curettage regimen in the treatment of cesarean scar pregnancy (CSP) following preventive uterine artery embolization (UAE).


METHODS
Thirty-three women were treated with D&C after UAE (group A) and 33 women were treated with operative hysteroscopy coupled with curettage after UAE (group B). The clinical outcomes of the two groups were compared.


RESULTS
There was no significant difference between the two groups with respect to the success rate, the intraoperative blood loss, the hysterectomy rate, the hospitalization time, the decline of serum β-hCG after surgery, the time of serum β-hCG resolution, the time of vaginal bleeding after surgery, the time to CSP mass disappearance, and the subsequent intrauterine pregnancies. The hospitalization cost in group B was higher than group A.


CONCLUSIONS
Both D&C and operative hysteroscopy coupled with curettage were successful in terminating a CSP. Hysteroscopy coupled with curettage regimen did not have significant advantages and good prognosis in dealing with the gestational sac type of CSP following preventive UAE compared with D&C regimen. Treatment should be individualized and several conditions must be considered.
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, People's Republic of China.
Zhi-Da
ZD
Qian
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, People's Republic of China. fbzhuxiaoming@163.com.
Li-Li
LL
Huang
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, People's Republic of China. fbzhuxiaoming@163.com.|Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou, People's Republic of China. fbzhuxiaoming@163.com.
Xiao-Ming
XM
Zhu
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002585:Cesarean Section; D002921:Cicatrix / Q000601:surgery*; D003131:Combined Modality Therapy; D004107:Dilatation and Curettage; D005260:Female; D058746:Gestational Sac; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy / Q000379:methods*; D007902:Length of Stay; D011247:Pregnancy; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*; D014592:Uterine Hemorrhage / Q000628:therapy
Cesarean scar pregnancy; Dilatation and curettage; Hysteroscopy; Treatment; Uterine artery embolization