[Clinical study of 22 cases of angular pregnancy treated with hysteroscopy combined with ultrasound or laparoscopy]

Objective: To investigate the clinical efficacy and safety of hysteroscopy combined with ultrasound or laparoscopy in the treatment of angular pregnancy. Methods: The clinical and pathological data of 22 patients with angular pregnancy who were treated at Fu Xing Hospital, Capital Medical University from January 2008 to June 2025 were retrospectively analyzed. According to the type of angular pregnancy, minimally invasive surgery was performed using hysteroscopy combined with ultrasound or laparoscopy. Operative time, intraoperative blood loss and therapeutic outcomes were assessed. Results: A total of 12 patients with type Ⅰ angular pregnancy underwent hysteroscopic surgery under ultrasound monitoring. The median operative time was 26.5 minutes, and the median intraoperative blood loss was 5.0 ml, and no residual tissue. Ten patients with type Ⅱ angular pregnancy underwent hysteroscopic surgery combined with laparoscopy, including 8 cases of hysteroscopic surgery under laparoscopic monitoring, one case of hysteroscopy combined laparoscopic cornuostomy, and one case of hysteroscopy combined laparoscopic wedge resection of the uterine horn. The median operative time was 64.5 minutes, and the median intraoperative blood loss was 15.0 ml; complete removal of gestational tissue was achieved in 10 cases. All surgeries were completed successfully without perioperative complications. Follow-up at 4 and 8 weeks postoperatively revealed no residual gestational tissue or other complications in any patient. Conclusions: Hysteroscopy combined with ultrasound or laparoscopy for angular pregnancy demonstrates favorable clinical efficacy and safety. However, strict case selection is essential, and surgical strategies should be flexibly tailored based on imaging characteristics and intraoperative assessment.