Clinical Curative Effects and Influencing Factors of Uterine Artery Chemoembolization Combined with Uterine Curettage Treating with Cesarean Scar Pregnancy Patients

Abstract

Objective. To explore the clinical curative effects of uterine arterial chemoembolization (UACE) combined with uterine curettage treating with cesarean scar pregnancy (CSP) patients, and analyze the influencing factors of postoperative efficacy. Methods. A total of 86 patients with CSP from January 2019 to December 2021 in the Gynecology ward of our hospital were selected and divided into the control group (n = 43) and the observation group (n = 43) according to the random number method. The control group was treated with an injection of methotrexate (MTX) combined with uterine curettage, and the observation group was treated with UACE combined with uterine curettage. Two months after the operation, the therapeutic effect, cesarean scar mass, and β-human chorionic gonadotropin (β-HCG) level were observed and compared between the two groups. The general conditions of patients in two groups were recorded, and the influencing factors of surgical efficacy in patients were analyzed using univariate analysis and a multivariate logistic regression model. Results. After treatment, the total effective rate of the observation group was significantly higher than that of the control group ( P < 0.05). The volume of intraoperative blood loss, hospitalization period, menstrual recovery time, mass disappearance time, and β-HCG recovery time of the observation group were lower than those of the control group ( P < 0.05). Single factor analysis showed that the number of cesarean sections, gestational age, the largest diameter of the gestational sac, the thinnest muscular layer, and the type of CSP can all affect postoperative efficacy ( P < 0.05). Multivariate logistic analysis showed that the gestational age, a maximum diameter of a gestational sac, the thinnest muscular layer, and the type of CSP were independent factors influencing the postoperative efficacy of the patients ( P < 0.05). Conclusion. UACE combined with uterine curettage for CSP can significantly improve the curative effect, reduce intraoperative bleeding, and improve the recovery time of postoperative-related symptoms. The gestational age of the patient, the maximum diameter of the gestational sac, the thinnest muscular layer, and the type of CSP can independently affect the therapeutic effect of CSP patients. Fully understanding the high-risk factors that affect the efficacy of treatment of CSP, timely preventive measures, and targeted care can effectively improve the prognosis and reduce the risk of CSP.

Advances in Treating Cesarean Scar Pregnancy: A Comprehensive Review of Techniques, Clinical Outcomes, and Fertility Preservation

“…Intraoperative angiography allows effective imaging of the anatomy with special attention to the uterine arteries and the possible presence of anastomoses that could hinder the procedure [ 23 ]. The standard dose used in the next step of the procedure is 50 mg of methotrexate, 25 mg in each of the uterine arteries, which directly supply blood to the embryo [ 26 ]. After the MTX is administered, occlusive agents such as polyvinyl alcohol and Gelfoam are injected through a delivery catheter to block the feeding vessel, prevent further blood flow to the gestational foci, and MTX migration.…”

“…Treatment efficacy was found to be influenced by size of the gestational mass, presence of fetal heartbeat, and type of CSP. Yu et al evaluated the effectiveness of chemoembolization by comparing it with an injection of methotrexate combined with uterine curettage [ 26 ]. They found that the total effective rate was significantly higher in the group of patients treated with chemoembolization ( P <0.05).…”

“…In patients who desire to preserve fertility, performing chemoembolization is debatable because of the risk of ovarian failure and infertility, as well as the increased risk of miscarriage, preterm labor, and postpartum hemorrhage [ 22 , 26 ]. Czuczwar et al compared the effects of treatment with supracervical hysterectomy, ulipristal acetate, and uterine artery embolization on ovarian reserve [ 32 ].…”

Retracted: Clinical Curative Effects and Influencing Factors of Uterine Artery Chemoembolization Combined with Uterine Curettage Treating with Cesarean Scar Pregnancy Patients

“…Tis article has been retracted by Hindawi following an investigation undertaken by the publisher [1]. Tis investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process:…”

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”