To investigate the factors influencing revascularization after gelatin sponge embolization of cesarean scar pregnancy, in order to improve the surgical procedure and increase the revascularization rate.

Retrospective analysis of 41 patients who underwent interventional treatment twice at Ningbo Women and Children's Hospital from January 2010 to December 2019. Case-based and surgical data were collected to assess vessel diameters, embolic sites and vessel recanalisation. All vessels (82) were divided into a revascularisation group (48) and an occlusion group (34) according to the recanalisation of the uterine arteries. A t-test was performed for the internal diameter of the uterine artery, a U-test for the interval between two procedures, a chi-square test for the site of embolism and the left and right sides, and a logistic regression analysis for each factor, with P < 0.05 being considered statistically significant.

Comparison of the case-based data between the two interventions showed statistically significant differences (P < 0.05) in age, gestation, time of surgery and post-operative clearance for haemorrhage.The revascularization rate after uterine artery embolization with gelatin sponge was 58.5% (48/82). The recanalisation rate was 36.4% in the descending segment, 44.0% in the transverse segment and 71.7% in the superior branch when embolized to different parts of the uterine artery, with statistically significant differences (χ² = 7.78, P = 0.023). By univariate logistic regression analysis, uterine artery embolization site from proximal to distal uterine artery increased the revascularization rate (OR = 2.359, 95%CI: 1.226 ~4.54, P = 0.013)with a Hosmer-Lemeshaw test of (χ² = 0.693, P = 0.424) and a prediction percentage of 65.9%.

The site of uterine artery embolization is a key factor for revascularization after applying gelatin sponge intervention for cesarean scar pregnancy, and the highest rate of revascularization was observed when embolized to the segment of the superior branch of the uterine artery, which may provide implications for the satisfactory degree of embolization in similar procedures.