Evaluation of the efficacy of laparoscopic resection for the management of exogenous cesarean scar pregnancy

• Published in: Fertility and sterility Vol. 101; no. 5; pp. 1501 - 1507
• Main Authors: Wang, Guangwei, M.M, Liu, Xiaofei, M.M, Bi, Fangfang, M.M, Yin, Lili, M.M, Sa, Rina, M.M, Wang, Dandan, M.M, Yang, Qing, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2014
• Subjects: Adult; Cesarean Section - adverse effects; Cicatrix - diagnosis; Cicatrix - epidemiology; Cicatrix - surgery; Disease Management; Exogenous cesarean scar pregnancy; Feasibility Studies; Female; Follow-Up Studies; Humans; hysteroscopy; Internal Medicine; laparoscopy; Laparoscopy - methods; Laparoscopy - standards; Obstetrics and Gynecology; Pregnancy; Retrospective Studies; Treatment Outcome; Young Adult; laparoscopy; Exogenous cesarean scar pregnancy; hysteroscopy
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2014.01.045

Objective To retrospectively analyze the clinical data of 71 patients with exogenous cesarean scar pregnancy (CSP) treated in our hospital in the past 2 years, to compare the outcomes of exogenous CSP treated with different methods, and to evaluate the safety and feasibility of laparoscopic resection of exogenous CSP. Design Comparative observational study. Setting Tertiary medical centers. Patient(s) 71 women with exogenous cesarean scar pregnancy. Intervention(s) Hysteroscopic resection of CSP, and laparoscopic resection of CSP. Main Outcome Measure(s) Operation time, intraoperative blood loss, postoperative drainage of the uterine cavity, postoperative days in hospital, time for β-human chorionic gonadotropin (β-hCG) to return to normal levels, absorption time of the mass. Result(s) For the laparoscopic group, the time for serum β-hCG to return normal levels and the postoperative drainage of the uterine cavity were significantly lower than in the patients who had undergone hysteroscopic resection. We found no statistically significant difference in the intraoperative blood loss and postoperative days in hospital between the two groups, but the operation time was longer in laparoscopic group. Conclusion(s) Laparoscopic surgery for a cesarean scar pregnancy has the advantages of a high success rate, fewer complications, and a shorter time for β-hCG levels to normalize. This procedure is especially suitable for the treatment of exogenous CSP.