Temporary uterine artery blocking and uterine artery embolization in treating cesarean scar pregnancy.

Abstract

Introduction: Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy. Lack of timely CSP treatment can lead to severe postpartum bleeding, affect fertility, and threaten patients' life and health.

Aim: This work explored the use of laparoscopic temporary uterine artery blocking (TUAB) and uterine artery embolization (UAE) in treating CSP.

Materials and methods: For the purpose of the study, 60 patients with CSP were selected and equally divided into the UAE group and the TUAB group. Both groups underwent cesarean scar lesion repair (CSLR) after the procedure. The differences in surgical outcomes, β‑human chorionic gonadotropin (β‑HCG) levels, ovarian reserve, endocrine function indicators, as well as the incidence of complications were compared between the groups.

Result: The TUAB group presented a shorter length of hospital stay, shorter vaginal bleeding time, shorter menstrual recovery time, and shorter mass disappearance time than the UAE group (all P <0.05). The patients in the TUAB group had lower β‑HCG, estradiol, and progesterone levels, and higher levels of luteinizing hormone and follicle‑stimulating hormone (all P <0.05). Furthermore, the TUAB patients had a larger mean ovary diameter, an increased antral follicle count, and an elevated level of anti‑Müllerian hormone, as compared with the individuals treated with UAE (all P <0.05). The total incidence of complications in the UAE and TUAB groups was 23.33% (7/30) and 6.67% (2/30), respectively (P <0.05).

Conclusions: Laparoscopic TUAB for CSLR proved to be a more effective and safer CSP treatment method than UAE.