Uterine Artery Embolization on Serum β-HCG Levels, Fertility Function and Clinical Efficacy in Patients With Cesarean Uterine Scar Pregnancy

Wenyang Zhu; Xiaofang Zhang; Chang Liu; Yang Liu; Wei Xu

doi:10.3389/fsurg.2022.838879

Uterine Artery Embolization on Serum β-HCG Levels, Fertility Function and Clinical Efficacy in Patients With Cesarean Uterine Scar Pregnancy

Front Surg. 2022 Feb 2:9:838879. doi: 10.3389/fsurg.2022.838879. eCollection 2022.

Authors

Wenyang Zhu¹, Xiaofang Zhang², Chang Liu³, Yang Liu⁴, Wei Xu⁵

Affiliations

¹ Department of Interventional Radiolody, The Affiliated Huaian Hospital of Xuzhou Medical University, Huaian, China.
² Department of Ultrasound, The Huaian Clinical College of Xuzhou Medical University, Huaian Maternity and Children Hospital, Huaian, China.
³ Department of Gynaecology, The Affiliated Huaian Hospital of Xuzhou Medical University, Huaian, China.
⁴ Department of Gynecology, The Huaian Clinical College of Xuzhou Medical University, Huaian Maternity and Children Hospital, Huaian, China.
⁵ Department of Interventional Radiolody, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Abstract

Objective: To analyze the therapeutic effect of uterine artery embolisation (UAE) in patients with cesarean section pregnancy (CSP) delivered by cesarean section and the effect on serum human chorionic gonadotrophin (β-HCG) levels and reproductive function.

Methods: In total 142 patients with CSP, The control group (n = 71) received Methotrexate (MTX) with ultrasound monitoring after admission and the research group (n = 71) was treated with UAE on basic of the control group. The two groups were compared in terms of treatment outcome, intraoperative bleeding, bed activity, vaginal bleeding and length of hospital stay, and serum follicle stimulating hormone (FSH), oestradiol (E2), luteinising hormone (LH) and β-HCG levels at 1 month postoperatively. The clinical symptoms (normalization of β-HCG and return of menstruation) and clinical outcomes (normal pregnancy, recurrent scar pregnancy) were compared between the two groups, as well as the occurrence of post-operative complications in both groups.

Results: Compared with the control group, the research group had a higher overall near-term effective rate, a lower recurrence rate of CSP in pregnancy, and a lower complication rate (P < 0.05); meanwhile, the time to get out of bed, postoperative vaginal bleeding, length of hospital stay, normalization of serum β-HCG, and return to menstruation were shorter in the research group than in the control group (P < 0.05); In addition, serum FSH, E2, LH and β-HCG levels improved better in the research group compared with the control group 1 month after surgery (P < 0.05).

Conclusion: The treatment of CSP patients with UAE can reduce the amount of intraoperative bleeding and the duration of vaginal bleeding, promote the improvement of patients' clinical symptoms, have less impact on the disruption of patients' sex hormone balance, reduce patients' surgical risks to a greater extent, preserve patients' normal fertility, and have better application.

Keywords: cesarean section; fertility function; serum β-HCG; uterine artery embolization; uterine scar pregnancy.