Abstract：
UNASSIGNED: Caesarean scar pregnancy (CSP) presents a significant clinical challenge owing to the associated risks of uterine scar rupture, severe haemorrhage and adverse maternal outcomes. This study aimed to assess the safety and efficacy of combining high-intensity focused ultrasound (HIFU) with suction curettage for treating CSP.
UNASSIGNED: We conducted a comprehensive search in four databases, namely PubMed, Web of Science, Embase and Cochrane Library, to identify published studies evaluating the use of HIFU combined with suction curettage to treat CSP. Intraoperative blood loss, treatment success rate, and reproductive results were the primary outcomes assessed.
UNASSIGNED: A total of 18 studies involving 1251 patients with CSP, all of whom received preoperative HIFU therapy were included. The average hospital stay was 6.22 days, the intraoperative blood loss was 26.29 ml and the incidence of adverse events was 15.60%, including abdominal or lower limb pain, fever, vaginal bleeding, haematuria and vomiting. Furthermore, post-treatment follow-up showed that serum β-human chorionic gonadotropin levels were rapidly normalized (average of 25.48 days) and menstruation returned (average of 33.03 days). The treatment had a remarkable success rate of 97.60% and a subsequent pregnancy rate of 68.70%.
UNASSIGNED: While the combination of HIFU and suction-curettage may induce common adverse effects such as lower abdominal or limb pain, these reactions typically do not necessitate therapeutic intervention. Additionally, the size of the gestational sac is a determinant of the procedure\'s success. In conclusion, HIFU combined with suction curettage demonstrates promising clinical efficacy, safety and favourable reproductive outcomes in managing CSP.
UNASSIGNED: We conducted a comprehensive search in four databases, namely PubMed, Web of Science, Embase and Cochrane Library, to identify published studies evaluating the use of HIFU combined with suction curettage to treat CSP. Intraoperative blood loss, treatment success rate, and reproductive results were the primary outcomes assessed.
UNASSIGNED: A total of 18 studies involving 1251 patients with CSP, all of whom received preoperative HIFU therapy were included. The average hospital stay was 6.22 days, the intraoperative blood loss was 26.29 ml and the incidence of adverse events was 15.60%, including abdominal or lower limb pain, fever, vaginal bleeding, haematuria and vomiting. Furthermore, post-treatment follow-up showed that serum β-human chorionic gonadotropin levels were rapidly normalized (average of 25.48 days) and menstruation returned (average of 33.03 days). The treatment had a remarkable success rate of 97.60% and a subsequent pregnancy rate of 68.70%.
UNASSIGNED: While the combination of HIFU and suction-curettage may induce common adverse effects such as lower abdominal or limb pain, these reactions typically do not necessitate therapeutic intervention. Additionally, the size of the gestational sac is a determinant of the procedure\'s success. In conclusion, HIFU combined with suction curettage demonstrates promising clinical efficacy, safety and favourable reproductive outcomes in managing CSP.
摘要：
由于子宫瘢痕破裂的相关风险，剖宫产瘢痕妊娠（CSP）提出了重大的临床挑战，严重出血和不良产妇结局。本研究旨在评估高强度聚焦超声（HIFU）联合抽吸刮治治疗CSP的安全性和有效性。
■我们在四个数据库中进行了全面搜索，即PubMed,WebofScience,Embase和Cochrane图书馆，确定已发表的评估HIFU联合吸刮术治疗CSP的研究。术中失血,治疗成功率,生殖结果是评估的主要结局.
■共有18项研究，涉及1251例CSP患者，所有接受术前HIFU治疗的患者均被纳入.平均住院时间为6.22天,术中出血量为26.29ml,不良事件发生率为15.60%,包括腹部或下肢疼痛，发烧,阴道出血,血尿和呕吐。此外，治疗后随访显示，血清β-人绒毛膜促性腺激素水平迅速恢复正常（平均25.48天），月经恢复（平均33.03天）。该治疗的成功率为97.60％，随后的妊娠率为68.70％。
■虽然HIFU和吸刮术的组合可能会引起常见的不良反应，例如下腹部或四肢疼痛，这些反应通常不需要治疗干预。此外,孕囊的大小是手术成功的决定因素。总之,HIFU联合吸刮术显示有希望的临床疗效，CSP管理的安全性和良好的生殖结局。
■我们在四个数据库中进行了全面搜索，即PubMed,WebofScience,Embase和Cochrane图书馆，确定已发表的评估HIFU联合吸刮术治疗CSP的研究。术中失血,治疗成功率,生殖结果是评估的主要结局.
■共有18项研究，涉及1251例CSP患者，所有接受术前HIFU治疗的患者均被纳入.平均住院时间为6.22天,术中出血量为26.29ml,不良事件发生率为15.60%,包括腹部或下肢疼痛，发烧,阴道出血,血尿和呕吐。此外，治疗后随访显示，血清β-人绒毛膜促性腺激素水平迅速恢复正常（平均25.48天），月经恢复（平均33.03天）。该治疗的成功率为97.60％，随后的妊娠率为68.70％。
■虽然HIFU和吸刮术的组合可能会引起常见的不良反应，例如下腹部或四肢疼痛，这些反应通常不需要治疗干预。此外,孕囊的大小是手术成功的决定因素。总之,HIFU联合吸刮术显示有希望的临床疗效，CSP管理的安全性和良好的生殖结局。
