Clinical analysis of cesarean scar pregnancy: report of 11 cases

Objective: To explore the early diagnosis and pertinent treatment of cesarean scar pregnancy(CSP).Methods: The clinical data of eleven patients with CSP were analyzed retrospectively.Results: Among the eleven cases,only 2 cases had clear diagnosis before artificial abortion.Three cases had uterine rupture and massive hemorrhage during artificial abortion.Six cases had vaginal massive hemorrhage after artificial abortion.All of them were diagnosed by colored B-ultrasound.Among the eleven cases,eight cases were treated by uterine artery embolization(UAE) combination with methotrexate(MTX) and had curettage 7-10 days after UAE.No case had the occurence of massive hemorrhage.All of them were successful.Two cases were treated with MTX and curratage with the help of ultrasound.There was about 400 ml bleeding during operation in every case.Only one case was treated by oral mifepristone and there was treated again by UAE because of massive hemorrhage during curettage.Conclusions: Color B-ultrasound,especially color Doppler transvaginal ultrasonography is the main method in diagnosis of CSP.UAE combination with MTX is one of the best effective treatment.