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Outcome of high-intensity focused ultrasound and uterine artery embolization in the treatment and management of cesarean scar pregnancy: A retrospective study.

Abstract The aim of the study was to compare the efficacy and safety between high-intensity focused ultrasound (HIFU) treatment and uterine artery embolization (UAE) treatment; we retrospectively analyzed 152 cases with cesarean scar pregnancy (CSP). Based on our inclusion and exclusion criteria, 152 patients (average age, 31.8 ± 4.6 years old) with CSP were eligible for the HIFU group (85 patients) or the UAE group (77 patients). All patients in 2 groups received the treatment with suction curettage under hysteroscopy prior to HIFU or UAE treatment and followed up for 12 months. The assessment criteria of treatment efficacy included the success rate, intraoperative blood loss, duration of vaginal bleeding, normal menstrual function recovery time, time for β-human chorionic gonadotrophin (β-HCG) back to normal level, duration of hospital stays, and other adverse effects. Following up for 12 months, the HIFU group was of less intraoperative blood loss (76.38 ± 22.89 vs 114.42 ± 30.34 mL, P = .02), shorter duration of postoperative vaginal bleeding (11.28 ± 3.65 vs 15.77 ± 7.24 days, P = .01) and lower adverse effects rate comparing to the UAE group. However, the HIFU group have longer time for the β-HCG recovery to the normal level (35.28 ± 9.86 vs 29.91 ± 7.29, P = .03). Additionally, there were no significantly statistic differences between the 2 groups in baseline characteristics, success rate, and average time of gestational sac disappeared and menstrual recovery and hospital stay. Thus, we concluded that the method of both HIFU and UAE combined with suction curettage under hysteroscopy is safe and effective in the management of CSP. Meanwhile, HIFU is a better therapy option than UAE for those women who are seeking complete relieve of symptom to gain fertility.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28746234
OWN - NLM
STAT- In-Process
DA  - 20170726
LR  - 20170726
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 30
DP  - 2017 Jul
TI  - Outcome of high-intensity focused ultrasound and uterine artery embolization in
      the treatment and management of cesarean scar pregnancy: A retrospective study.
PG  - e7687
LID - 10.1097/MD.0000000000007687 [doi]
AB  - The aim of the study was to compare the efficacy and safety between
      high-intensity focused ultrasound (HIFU) treatment and uterine artery
      embolization (UAE) treatment; we retrospectively analyzed 152 cases with cesarean
      scar pregnancy (CSP). Based on our inclusion and exclusion criteria, 152 patients
      (average age, 31.8 +/- 4.6 years old) with CSP were eligible for the HIFU group
      (85 patients) or the UAE group (77 patients). All patients in 2 groups received
      the treatment with suction curettage under hysteroscopy prior to HIFU or UAE
      treatment and followed up for 12 months. The assessment criteria of treatment
      efficacy included the success rate, intraoperative blood loss, duration of
      vaginal bleeding, normal menstrual function recovery time, time for beta-human
      chorionic gonadotrophin (beta-HCG) back to normal level, duration of hospital
      stays, and other adverse effects. Following up for 12 months, the HIFU group was 
      of less intraoperative blood loss (76.38 +/- 22.89 vs 114.42 +/- 30.34 mL, P =
      .02), shorter duration of postoperative vaginal bleeding (11.28 +/- 3.65 vs 15.77
      +/- 7.24 days, P = .01) and lower adverse effects rate comparing to the UAE
      group. However, the HIFU group have longer time for the beta-HCG recovery to the 
      normal level (35.28 +/- 9.86 vs 29.91 +/- 7.29, P = .03). Additionally, there
      were no significantly statistic differences between the 2 groups in baseline
      characteristics, success rate, and average time of gestational sac disappeared
      and menstrual recovery and hospital stay. Thus, we concluded that the method of
      both HIFU and UAE combined with suction curettage under hysteroscopy is safe and 
      effective in the management of CSP. Meanwhile, HIFU is a better therapy option
      than UAE for those women who are seeking complete relieve of symptom to gain
      fertility.
FAU - Hong, Yufeng
AU  - Hong Y
AD  - aDepartment of Gynecology, The Second Affiliated Hospital of Shaanxi University
      of Chinese Medicine, Xianyang, Shaanxi bDepartment of Ultrasound cDepartment of
      Birth Control, Tangshan Maternity and Child Health Care Hospital, Tangshan, Hebei
      dEmergency Department, Changhai Hospital, Shanghai, China.
FAU - Guo, Quanwei
AU  - Guo Q
FAU - Pu, Yingjie
AU  - Pu Y
FAU - Lu, Dongmei
AU  - Lu D
FAU - Hu, Min
AU  - Hu M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/07/27 06:00
MHDA- 2017/07/27 06:00
CRDT- 2017/07/27 06:00
AID - 10.1097/MD.0000000000007687 [doi]
AID - 00005792-201707280-00065 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(30):e7687. doi: 10.1097/MD.0000000000007687.