Application Value of Uterine Compression Suture through Laparoscopy in Treating Cesarean Scar Pregnancy_West China Medical Journal

Authors：

 NieXiaocheng

Department of Gynecology and Obstetrics, Sichuan Provincial Hospital for Womenn and Children, Chengdu, Sichuan 610045, P. R. China;

Corresponding?author：

Keywords：

Laparoscopy; Uterine compression suture; Cesarean scar pregnancy; Application value

DOI：

10.7507/1002-0179.201600286

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Objective To investigate the value of uterine compression suture through laparoscopy in the treatment of cesarean scar pregnancy (CSP). Methods A random controlled study was conducted on 85 CSP patients diagnosed between September 2013 and December 2014. The patients were randomly divided into control group (n=43) and study group (n=42). The control group received routine evacuation under laparoscopy, while the study group received routine evaluation under laparoscopy combined with uterine compression suture. The efficacy of the two treatments were compared and analyzed. Results The operation time of the control group and the study group was (36.6±17.7) and (45.6±14.8) minutes, respectively. Total amount of bleeding during and after the operation was (207.9±165.8) and (96.1±29.0) mL for the two groups of patients, and the above differences were statistically significant (P＜0.05). There was no significant difference in the indicators of anal exhaust time, hospitalization stay, blood β-human chorionic gonadotrophin clearance time, and menstruation recovery time between the two groups (P>0.05). Conclusion Uterine compression suture through laparoscopy is a safe and reliable method to reduce the bleeding of CSP, which is easy to perform and worthy of promotion.

Citation： NieXiaocheng. Application Value of Uterine Compression Suture through Laparoscopy in Treating Cesarean Scar Pregnancy. West China Medical Journal, 2016, 31(6): 1065-1068. doi: 10.7507/1002-0179.201600286 Copy

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2.	武欣, 何以豐, 吳學浙, 等. 剖宮產切口瘢痕妊娠(CSP)子宮動脈栓塞(UAE)后宮腹腔鏡聯合手術和刮宮術的比較[J]. 復旦學報: 醫學版, 2013, 40(4): 447-453.
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6.	陳誠, 常青. 子宮體部手術后不良瘢痕形成的預防措施研究進展[J]. 重慶醫學, 2013, 42(12): 1419.
7.	El-Mazny A, Abou-Salem N, EI-Khayat W, et al. Diagnostic correlation between sonohysterography and hysteroscopy in the assessment of uterine cavity after cesarean section[J]. Middle East Fertil Soc J, 2011, 16(1): 72-76.
8.	陳鶴立, 王沂峰. 子宮切口瘢痕妊娠的診治進展[J]. 廣東醫學, 2012, 33(22): 3499.
9.	羅群英. 高強度聚焦超聲治療子宮切口妊娠臨床療效分析[J]. 數理醫藥學雜志, 2015, 28(2): 202-203.
10.	Lee CL, Wang CJ, Chao A, et al. Laparoscopic management of an ectopic pregnancy in a previous caesarean section scar[J]. Hum Reprod, 1999, 14(5): 1234-1236.
11.	程春霞, 薛敏. 宮、腹腔鏡聯合治愈剖宮產子宮切口部位妊娠一例[J]. 實用婦產科雜志, 2002(18): 373.
12.	Blynch C, Coker AH. The blynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported[J]. Br J Obstet Gynaecol, 1997, 104(3): 372-375.
13.	佟珊. 子宮加壓縫合法治療子宮收縮乏力性產后出血的療效觀察[J]. 中國醫藥指南, 2015, 13(3): 179.
14.	蘇站勤, 高雪梅. 剖宮產瘢痕妊娠研究現狀及治療進展[J]. 中國婦產科臨床雜志, 2012, 13(6): 467-470.
15.	Halperin R, Schneider D, Mendlovic S. Uterine-preserving emergency surgery for cesarean scar pregnancies: another medical solution to an iatrogenic proble[J]. Fertil Steril, 2009, 91(6): 2623-2627.
16.	吳曉蘭, 劉帥. 腹腔鏡子宮動脈結扎術在宮頸或瘢痕切口妊娠治療中的應用[J]. 國際生殖健康/計劃生育雜志, 2011, 30(6): 438-439.
17.	Raba G. Effect of internal iliac artery ligation on ovarian blood supply and ovarian reserve[J]. Climacteric, 2011, 14(1): 54-57.
18.	歐陽棟, 朱斌, 何曉音. 子宮動脈栓塞術治療剖宮產后切口妊娠26 例臨床分析[J]. 中國內鏡雜志, 2013, 19(6): 631-635.
19.	陳玉清, 常亞杰, 馮麗萍. 子宮切口瘢痕妊娠治療策略分析[J]. 實用醫學雜志, 2010, 26(18): 3383-3385.

1. Rotas MA, Haberman S, Levgur M. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management[J]. Obstet Gynecol, 2006, 107(6): 1373-1381.
2. 武欣, 何以豐, 吳學浙, 等. 剖宮產切口瘢痕妊娠(CSP)子宮動脈栓塞(UAE)后宮腹腔鏡聯合手術和刮宮術的比較[J]. 復旦學報: 醫學版, 2013, 40(4): 447-453.
3. Ash A, Smith A, Maxwell D. Caesarean scar pregnancy[J]. BJOG, 2007, 114(3): 253-263.
4. Kirk E, Bourne T. Diagnosis of ectopic pregnancy with ultrasound[J]. Best Pract Res Clin Obstet Gynaecol, 2009, 23(4): 501-508.
5. Uysal F, Uysal A, Adam G, et al. Cesarean scar pregnancy: diagnosis, management, and follow-up[J]. J Ultrasound Med, 2013, 32(7): 1295-1300.
6. 陳誠, 常青. 子宮體部手術后不良瘢痕形成的預防措施研究進展[J]. 重慶醫學, 2013, 42(12): 1419.
7. El-Mazny A, Abou-Salem N, EI-Khayat W, et al. Diagnostic correlation between sonohysterography and hysteroscopy in the assessment of uterine cavity after cesarean section[J]. Middle East Fertil Soc J, 2011, 16(1): 72-76.
8. 陳鶴立, 王沂峰. 子宮切口瘢痕妊娠的診治進展[J]. 廣東醫學, 2012, 33(22): 3499.
9. 羅群英. 高強度聚焦超聲治療子宮切口妊娠臨床療效分析[J]. 數理醫藥學雜志, 2015, 28(2): 202-203.
10. Lee CL, Wang CJ, Chao A, et al. Laparoscopic management of an ectopic pregnancy in a previous caesarean section scar[J]. Hum Reprod, 1999, 14(5): 1234-1236.
11. 程春霞, 薛敏. 宮、腹腔鏡聯合治愈剖宮產子宮切口部位妊娠一例[J]. 實用婦產科雜志, 2002(18): 373.
12. Blynch C, Coker AH. The blynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported[J]. Br J Obstet Gynaecol, 1997, 104(3): 372-375.
13. 佟珊. 子宮加壓縫合法治療子宮收縮乏力性產后出血的療效觀察[J]. 中國醫藥指南, 2015, 13(3): 179.
14. 蘇站勤, 高雪梅. 剖宮產瘢痕妊娠研究現狀及治療進展[J]. 中國婦產科臨床雜志, 2012, 13(6): 467-470.
15. Halperin R, Schneider D, Mendlovic S. Uterine-preserving emergency surgery for cesarean scar pregnancies: another medical solution to an iatrogenic proble[J]. Fertil Steril, 2009, 91(6): 2623-2627.
16. 吳曉蘭, 劉帥. 腹腔鏡子宮動脈結扎術在宮頸或瘢痕切口妊娠治療中的應用[J]. 國際生殖健康/計劃生育雜志, 2011, 30(6): 438-439.
17. Raba G. Effect of internal iliac artery ligation on ovarian blood supply and ovarian reserve[J]. Climacteric, 2011, 14(1): 54-57.
18. 歐陽棟, 朱斌, 何曉音. 子宮動脈栓塞術治療剖宮產后切口妊娠26 例臨床分析[J]. 中國內鏡雜志, 2013, 19(6): 631-635.
19. 陳玉清, 常亞杰, 馮麗萍. 子宮切口瘢痕妊娠治療策略分析[J]. 實用醫學雜志, 2010, 26(18): 3383-3385.

West China Medical Journal

Application Value of Uterine Compression Suture through Laparoscopy in Treating Cesarean Scar Pregnancy

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