Abstract：
To compare the efficacy and safety of different treatment options for cervical pregnancy (CP).
A total of 74 patients diagnosed with CP at Hunan Provincial Maternal and Child Health Care Hospital between January 2016 and September 2022 were retrospectively analyzed. Among them, 31 were treated with uterine artery embolization (UAE) followed by hysteroscopic curettage, 34 were treated with hysteroscopic curettage alone, and nine were treated with high-intensity focused ultrasound (HIFU) followed by hysteroscopic curettage. Medical records and pregnancy outcomes were analyzed.
There were no significant differences in age, gravidity, parity, abortion, or preoperative hemoglobin levels among the patients in the three groups; however, significant differences in gestational age, gestational sac diameter, preoperative β-hCG, and presence of cardiac pulsation were observed (p < 0.05). After treatment, there was no conversion to laparotomy, and the uterus was preserved in all patients. Significant differences in blood loss during curettage, hospitalization costs, hospital days, menstrual recovery interval, β-hCG decline rates, retained products of conception, and intrauterine adhesions rate among the three groups were observed (p < 0.05). There were no significant differences in the placement of the uterine Foley balloon, effective curettage rate, pre-and postoperative hemoglobin decline, live birth rate, or proportion of subsequent pregnancies among the three groups.
Our results showed that hysteroscopic curettage, HIFU, and UAE followed by hysteroscopic curettage are safe and effective for treating patients with CP. Compared with the UAE, HIFU has the advantages of lower hospitalization costs, shorter hospital stays, and shorter menstrual recovery intervals.
A total of 74 patients diagnosed with CP at Hunan Provincial Maternal and Child Health Care Hospital between January 2016 and September 2022 were retrospectively analyzed. Among them, 31 were treated with uterine artery embolization (UAE) followed by hysteroscopic curettage, 34 were treated with hysteroscopic curettage alone, and nine were treated with high-intensity focused ultrasound (HIFU) followed by hysteroscopic curettage. Medical records and pregnancy outcomes were analyzed.
There were no significant differences in age, gravidity, parity, abortion, or preoperative hemoglobin levels among the patients in the three groups; however, significant differences in gestational age, gestational sac diameter, preoperative β-hCG, and presence of cardiac pulsation were observed (p < 0.05). After treatment, there was no conversion to laparotomy, and the uterus was preserved in all patients. Significant differences in blood loss during curettage, hospitalization costs, hospital days, menstrual recovery interval, β-hCG decline rates, retained products of conception, and intrauterine adhesions rate among the three groups were observed (p < 0.05). There were no significant differences in the placement of the uterine Foley balloon, effective curettage rate, pre-and postoperative hemoglobin decline, live birth rate, or proportion of subsequent pregnancies among the three groups.
Our results showed that hysteroscopic curettage, HIFU, and UAE followed by hysteroscopic curettage are safe and effective for treating patients with CP. Compared with the UAE, HIFU has the advantages of lower hospitalization costs, shorter hospital stays, and shorter menstrual recovery intervals.
摘要：
■比较不同治疗方案对宫颈妊娠（CP）的疗效和安全性。
■对2016年1月至2022年9月湖南省妇幼保健院确诊为CP的74例患者进行回顾性分析。其中,31例患者采用子宫动脉栓塞术（UAE），然后进行宫腔镜刮治，34例患者仅接受宫腔镜刮治治疗，9例接受高强度聚焦超声（HIFU）治疗，然后进行宫腔镜刮除术。分析病历和妊娠结局。
■年龄没有显著差异，妊娠,奇偶校验，流产,三组患者的术前血红蛋白水平;然而,胎龄有显著差异，孕囊直径，术前β-hCG,并观察到心脏搏动的存在（p<0.05）。治疗后,没有转换为剖腹手术，所有患者都保留了子宫。刮宫期间失血的显着差异，住院费用，医院的日子,月经恢复间隔，β-hCG下降率，保留的受孕产品，观察3组宫腔粘连发生率(p<0.05)。子宫Foley球囊的放置没有显着差异，有效刮宫率，术前和术后血红蛋白下降，活产率,或三组中后续妊娠的比例。
■我们的结果显示，HIFU,UAE和宫腔镜下刮宫治疗CP患者安全有效。与阿联酋相比，HIFU具有住院费用低的优势，缩短住院时间,和较短的月经恢复间隔。
■对2016年1月至2022年9月湖南省妇幼保健院确诊为CP的74例患者进行回顾性分析。其中,31例患者采用子宫动脉栓塞术（UAE），然后进行宫腔镜刮治，34例患者仅接受宫腔镜刮治治疗，9例接受高强度聚焦超声（HIFU）治疗，然后进行宫腔镜刮除术。分析病历和妊娠结局。
■年龄没有显著差异，妊娠,奇偶校验，流产,三组患者的术前血红蛋白水平;然而,胎龄有显著差异，孕囊直径，术前β-hCG,并观察到心脏搏动的存在（p<0.05）。治疗后,没有转换为剖腹手术，所有患者都保留了子宫。刮宫期间失血的显着差异，住院费用，医院的日子,月经恢复间隔，β-hCG下降率，保留的受孕产品，观察3组宫腔粘连发生率(p<0.05)。子宫Foley球囊的放置没有显着差异，有效刮宫率，术前和术后血红蛋白下降，活产率,或三组中后续妊娠的比例。
■我们的结果显示，HIFU,UAE和宫腔镜下刮宫治疗CP患者安全有效。与阿联酋相比，HIFU具有住院费用低的优势，缩短住院时间,和较短的月经恢复间隔。
