Clinical efficacy of vaginal scar pregnancy lesion resection combined with uterine repair for type Ⅱ/Ⅲ cesarean scar pregnancy patients
Objective To analyze the clinical efficacy of vaginal scar pregnancy lesion resection combined with uterine repair in treating patients with Type Ⅱ/Ⅲ cesarean scar pregnancy (CSP) and its impact on postoperative recovery,providing sup-port for clinical treatment plans for CSP patients.Methods This retrospective study selected 103 Type Ⅱ/Ⅲ CSP patients treated in our hospital from June 2018 to June 2020.Patients were assigned to control group (50 cases) study group (53 ca-ses) based on different treatment methods.The control group underwent uterine artery chemoembolization combined with ultrasound-guided curettage,while the study group received vaginal scar pregnancy lesion resection combined with uterine repair.Clinical efficacy,surgical indicators,postoperative recovery,pre-and post-treatment progesterone,and β-HCG lev-els were compared between the two groups.Additionally,the recurrence of cesarean scar pregnancy and normal pregnancy rates were compared during a two-year follow-up.Results The overall response rate in the study group was significantly higher than that in the control group[90.56% (48/53) vs.74.00% (37/50);x2=4.896,P=0.027].There was no sig-nificant difference in progesterone and β-HCG levels between the two groups before treatment (P>0.05).Post-treatment,both progesterone and β-HCG levels were significantly lower in the study group compared to the control group (P<0.05).The study group had less intraoperative blood loss,longer time of operation,and shorter time to ambulation and length of hospital stay compared to the control group,all with significant differences (P<0.05).Postoperative recovery time for nor-mal menstruation,vaginal bleeding,β-HCG normalization,and disappearance of intrauterine masses were significantly shor-ter in the study group than in the control group (P<0.05).The two-year recurrence rate of cesarean scar pregnancy in the stud-y group was significantly lower than that in the control group[0(0/53) vs.14.00% (7/50);x2=5.904,P=0.015].The two-year normal pregnancy rate in the study group was significantly higher than that in the control group[66.04% (35/53) vs.34.00% (17/50);x2=10.564,P=0.001].Conclusion Vaginal scar pregnancy lesion resection combined with uterine repair is highly ef-fective for treating patients with Type Ⅱ/Ⅲ CSP.It reduces intraoperative blood loss,promotes postoperative recovery,decreases the recurrence risk of cesarean scar pregnancy,and increases the rate of normal pregnancy.