Transvaginal surgical management of cesarean scar pregnancy: analysis of 49 cases from one tertiary care center

Objective: To investigate the safety and effectiveness of transvaginal surgical management of cesarean scar pregnancy (CSP). Study design: Retrospective analysis of 49 CSP patients who received transvaginal surgery in our hospital between December 2009 and April 2013. Patients were divided into two groups. Group A (30 patients) was defined as patients who had not received any treatment before transvaginal surgical management. Group B (19 patients) referred to patients who had received any previous treatment. Preoperative, intraoperative and postoperative data of both groups were collected and analyzed retrospectively. Results: Preoperative serum beta-hCG level, preoperative hemoglobin level and average serum beta-hCG resolution time of group A and group B were 53,458.50 (36,382.00-94,100.50) versus 9779.00 (932.50-29623.00) U/l, 123.87 +/- 10.95 versus 109.94 +/- 16.05 g/l and 3.55 +/- 1.81 versus 1.83 +/- 1.15 weeks (P < 0.05). Vaginal bleeding and gestational age in group A were significantly lower than in group B, 2.5(0.50-11.00) versus 15.00(3.50-31.50) days and 52.50(46.50-56.70) versus 60.00(48.00-90.00) days, respectively (P < 0.05). The operative time, estimated blood loss, postoperative hospital stay, hospitalization expenses and menstruation recovery time of group A and group B were 56.61 +/- 24.40 versus 67.56 +/- 43.52 min, 45.65 +/- 27.83 versus 76.67 +/- 50.87 ml, 5.10 +/- 2.89 versus 5.33 +/- 3.99 days, 9001.94 +/- 1848.37 versus 11,032.33 +/- 5534.14 RMB and 1.16 +/- 0.47 versus 1.26 +/- 0.63 month respectively, which were similar between the two groups (P > 0.05). The intraoperative complication rate in group A was significantly lower than group B, 0 (0/30) versus 21.05% (4/19) (P < 0.05). The postoperative complication rate and total complication rate in group A and group B were 10.00% (3/30) versus 21.05% (4/19) and 10.00% (3/30) versus 31.58% (6/19) (P > 0.05), respectively. Conclusion: Transvaginal surgery is an effective and relatively safe treatment option for CSP patients. (C) 2014 Elsevier Ireland Ltd. All rights reserved.