A comparative study of dilation and curettage for cesarean scar pregnancy in different time after uterine arterial embolization therapy

Objective To compare the clinical outcomes of dilation and curettage at different stages after uterine arterial embolization therapy in the treatment of cesarean scar pregnancy (CSP). Methods The uterine artery embolization (UAE) was performed in 20 cases of CSP in our hospital between March 2014 and December 2016. According to the time performing uterine curettage after embolization, the patients were divided into Group A (within 24 h), Group B (24 h to 48h) and Group C (48 h to 72 h). The dilation and curettage surgery was performed under the guidance of colored ultrasound. The intraoperative blood loss, length of hospital stay, time to β-HCG recovery and uterine recovery were monitored and analyzed. Results All cases underwent a successful embolization. The intraoperative blood loss of Group A, B and C were (9. 3 ±1. 9) ml, (17. 1 ±3. 9) ml and (110. 0 ±54. 4) ml, respectively. The length of hospital stay of Group A, B and C were (7. 0 ±2. 4) d, (5. 9 ±2. 7) d and (11. 1 ±2. 1) d, respectively; The time to β-HCG recovery in Group A, B and C were (18. 6 ±5. 2) d and (19. 0 ±3. 3) d, (21. 2 ±4. 4) d, respectively; The time to uterine recovery in Group A, B and C were (41. 1 ±1. 1) d, (41. 1 ±1. 1) d and (41. 5 ±1. 0) d, respectively. The intraoperative blood loss of Group A and Group B were significantly lower than that of Group C (P < 0. 01); the length of hospital stay in Group A and B were significantly shorter than that in Group C (P < 0. 01). There were no significant differences in the time to β-HCG recovery and uterine recovery among three groups. Conclusion Uterine artery embolization combined with ultrasound guided curettage for uterine scar pregnancy is with less trauma, less complications and curative effect, and can retain the uterus; uterine artery embolization within 24 h after curettage is the best time for the treatment of CSP.