A combination of laparoscopy and bilateral uterine artery occlusion for the treatment of type II cesarean scar pregnancy: a retrospective analysis

J Int Med Res. 2024 Apr;52(4):3000605241241010. doi: 10.1177/03000605241241010.

Abstract

Objective: We investigated the efficacy of a combination of laparoscopy and bilateral uterine artery occlusion (BUAO) for the treatment of type II cesarean scar pregnancy (CSP).

Methods: Patients with type II CSP underwent laparoscopy + bilateral uterine artery embolization (control group) or laparoscopy + BUAO (study group). Data regarding the duration of surgery, intraoperative hemorrhage, postoperative complications, the duration of the hospital stay, and the costs of hospitalization were retrospectively collected. One year later, the time to the return of the β-human chorionic gonadotropin (β-hCG) concentration to normal and to the return of menstruation were compared.

Results: The duration of surgery, time to the return of menstruation, and incidence of postoperative complications in the study group were significantly less than in the control group, but there was no significant difference in the time for β-hCG to return to normal or the volume of intraoperative hemorrhage. The duration of hospitalization and costs for the control group were higher than those for the study group.

Conclusion: Laparoscopy in combination with BUAO is associated with minimal trauma, rapid recovery, a short duration of surgery, low cost of hospitalization, and a low postoperative complication rate. Thus, it represents a useful new surgical treatment for type II CSP.

Keywords: Type II cesarean scar pregnancy; bilateral uterine artery embolization; bilateral uterine artery occlusion; duration of surgery; hospitalization; intraoperative hemorrhage; laparoscopy; menstruation; postoperative complication.

MeSH terms

  • Adult
  • Cesarean Section* / adverse effects
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Cicatrix*
  • Female
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Length of Stay
  • Postoperative Complications / etiology
  • Pregnancy
  • Pregnancy, Ectopic / etiology
  • Pregnancy, Ectopic / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Uterine Artery / surgery
  • Uterine Artery Embolization* / economics
  • Uterine Artery Embolization* / methods

Substances

  • Chorionic Gonadotropin, beta Subunit, Human