To explore the application and influential factors of uterine artery embolization (UAE) in the treatment of caesarean scar pregnancy (CSP) .

The retrospective study included 76 cases of CSP who planed to accept conservative therapy (dilation and curettage combined with MTX injected intramuscularly) , including 26 patients treated with effective treatment (group A) and 50 patients treated with Methotrexate+ UAE (group B) . The patients' clinical parameters, adverse reactions and complications were recorded. Univariate analysis and multivariate logistic regression model were used to analyze the factors of choosing UAE, and the receiver operating characteristic curve (ROC) was further utilized to gain the optimal cutoff.

The univariate analysis showed that there was no significant difference in age, parity, parity, history of cesarean section and serum β-HCG level between the two groups. The menolipsis time (P=0.012) , gestational sac size (P=0.031) , thickness of scar myometrium (P=0.002) and scar types (P=0.036) in group A were significantly different from those in group B. The multivariate logistic regression model showed that the menstruation time and thickness of scar myometrium were independent factors of choosing UAE. The optimal cutoff for menolipsis time and thickness of scar myometrium were 51 d and 2.7 mm, respectively (the areas under their corresponding ROC were 0.813 and 0.808) .

UAE is effective in preventing massive hemorrhage during treatment of CSP, especially for the cases with menolipsis time ≥51 d and thickness of scar myometrium ≤2.7 mm.