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Type 2 Cesarean Scar Pregnancy Successfully Treated via Hysteroscopy-Assisted Laparoscopy
Feng Qi1, Ze-Ying Chai2, Man-Man Liu2
1Department of Gynecology and Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Zhejiang Province, China (Drs. Qi and Lv); Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Affiliated with Wenzhou Medical University, Linhai, Zhejiang Province, China (Drs. Qi, Chai, Liu, Zheng, Zhu, and Chen).
Study Objective:
To evaluate the efficacy of hysteroscopy-assisted laparoscopy as a treatment strategy for type 2 cesarean scar pregnancy at gestational age >8 weeks.
Design:
Retrospective case series (Canadian Task Force classification II-3).
Setting:
A tertiary hospital.
Patients:
Eight women with type 2 cesarean scar pregnancy at a gestational age >8 weeks.
Interventions:
All patients underwent hysteroscopy-assisted laparoscopic resection and isthmus repair of cesarean scar pregnancy.
Measurements And Main Results:
All patients underwent removal of the cesarean scar pregnancy and complete repair of the uterine scar defect. The median operative time was 123.0 minutes (range, 100-168 minutes), median blood loss was 65.0 mL (range, 20-100 mL), and median length of hospital stay was 9.1 days (range, 8-12 days). There were no adverse reactions. The mean time to serum β-human chorionic gonadotropin (β-HCG) resolution was 22.9 days (range, 14-30 days), and menstruation resumed after 9 to 15 days with serum β-HCG returning to nondetectable levels. There was no recurrence of cesarean scar pregnancy at long-term follow-up.
Conclusion:
Hysteroscopy-assisted laparoscopy may be an effective treatment for patients with type 2 cesarean scar pregnancy at gestational age >8 weeks.
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