Abstract:
Objective: To investigate the clinical value and technical essentials of uterine arterial embolization before curettage in patients with cesarean scar pregnancy.
Methods: A total of 347 patients with cesarean scar pregnancy from January 2012 to January 2017 were collected and treated with "layered" absorbable gelatin sponge particles to embolize the uterine artery, and curettage was performed under ultrasound scanning within 72 h after embolization. The results of digital subtraction angiography (DSA) and embolization, the pain after embolization, the amount of bleeding in curettage and the related follow-up data were analyzed.
Results: Among the 347 patients who successfully received DSA, embolization was successfully performed in 343 cases. The technical success rate was 98.85% (343/347) . Four cases were not treated with embolization after DSA. Among the 347 cases, 22 cases had abnormal blood vessels, accounting for 6.34%. And the patients with heterogeneous blood vessels had higher blood loss than those with undifferentiated blood vessels. The 347 patients were successfully performed with curettage under ultrasound scanning, the amount of bleeding in curettage was 10-2 000 ml. Among the 347 patients, 302 cases were less than 50 ml, 33 cases were 50-600 ml, and 12 cases were more than 600 ml. After embolization, 74 cases were treated within less than 24 h, 234 cases were treated within 24-48 h, and 39 cases were within 48-72 h. There was no statistically significant difference in the amount of blood loss at different time intervals after embolization. There was no significant difference in the amount of blood loss between the 6th week of pregnancy and the 7th to 9th week of curettage. The amount of blood loss in the curettage at 10 to 12 weeks of pregnancy was significantly greater than that of patients within 9 weeks of pregnancy. The difference was statistically significant.
Conclusion: Pre-embolization of the uterine feeding artery within 72 h before surgery can effectively prevent major bleeding during curettage and does not significantly affect ovarian function.
Key words:
Cesarean scar pregnancy,
Uterine artery embolization,
Curettage,
Absorbable gelatin sponge,
Ovarian function
Zengtao Sun, Lei Zhang, Wei Liu, Jijun Li, Yinchang Wang. Clinical value of uterine artery embolization before uterine curettage with cesarean scar pregnancy[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2018, 06(03): 204-208.