The Effect of Prophylactic Uterine Artery Embolisation On Reproductive Outcomes In Caesarean Scar Pregnancy Patients: A Propensity Score-Matched Study

Abstract

Purpose: This study aimed to investigate the effect of prophylactic uterine artery embolisation (UAE) on reproductive outcomes in caesarean scar pregnancy (CSP) patients.Methods: Clinical data of CSP patients diagnosed at Shengjing Hospital of China Medical University from January 2014 to December 2019 were collected. According to inclusion and exclusion criteria, 181 patients with reproductive needs were selected and divided into UAE group (n = 51) and non-UAE group (n = 130) according to whether the patient received preventive UAE before their hysteroscopic or laparoscopic operation. The basic characteristics and pregnancy outcomes of individuals of the groups were compared, and propensity score matched (PSM) analysis was used to produce 37 matched pairs.Results: Before PSM, the UAE group had a thinner muscle layer, larger mass size, and higher serum human chorionic gonadotropin level than the non-UAE group. The pregnancy rate and live birth rate of the UAE group were 54.9% and 61.9%, respectively, which were lower than those of the non-UAE group (61.5% and 66.7%), but no statistical differences were observed. Post-PSM, no significant differences between basic characteristics of the groups were observed. The pregnancy rate of the UAE group was 51.4%, lower than that of the non-UAE group (73.0%). The live birth rate of the UAE group was 64.3%, also lower than that of the non-UAE group (72.7%); however, the difference was not statistically significant.Conclusion: Prophylactic UAE is a safe and effective adjuvant treatment for CSP, and has no significant effect on subsequent pregnancy and live birth rates.