Different procedures for management of caesarean scar pregnancy

Objective:To explore the therapeutic effect of different Methods for management of caesarean scar pregnancy(CSP)． Methods:Eight patients with CSP were included in the study． Two of the cases suffered from vagina bleeding after treatment failure in other hospitals and received emergency uterine artery embolization and methotrexate chemotherapy after surgery，1 case was treated with mifepristone alone，1 case outburst vagina bleeding during the therapy of mifepristone combined with methotrexate，and then underwent emergency uterine artery embolization and hysteroscopy CSP lesion resection 1 week later，2 cases were performed routine hysteroscopy CSP lesion resection and the other 2 cases resorted to abdominal CSP lesion excision repair，for 1 case had intraoperative bleeding in the hysteroscopy check and the other one was found to have uterine scar diverticulum pregnancy by hysteroscopy check． Results:All the 8 cases were cured and the uteri were retained． Among them，1 case treated by only mifepristone achieved successful result，2 cases underwent hysteroscopy surgery after drug treatment failure，and 2 cases resorted to abdominal surgery after drug treatment failure and hysteroscopy surgery failure;3 cases that suffered from serious vagina bleeding got successful hemostasis with uterine artery embolization and then underwent drug therapy or hysteroscopy surgery． Conclusions:Simple drug therapy and hysteroscopy surgery must aim at certain indications，and uterine artery embolization can quickly stop bleeding． Combination therapy of drugs or operation with embolism is safe and effective for management of caesarean scar pregnancy．