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Transvaginal Surgical Management of Cesarean Scar Pregnancy II (CSP-II): An Analysis of 25 Cases

Hui Zhang, Junrong Shi, Yong’An Yang, Yijuan Liang, Xinping Gao, Jing Wang, Hui Liu, Bingge Wu, Jinhui Zhao

Department of Obstetrics and Gynecology, Affiliated Hospital of Hebei University, Baoding, Hebei, China (mainland)

Med Sci Monit 2015; 21:3320-3326

DOI: 10.12659/MSM.893776

Available online:

Published: 2015-11-01

BACKGROUND: The aim of this study was to investigate the feasibility and clinical value of transvaginal surgical treatment for cesarean scar pregnancy (CSP-II).
MATERIAL AND METHODS: This study was a retrospective analysis of 25 CSP-II patients who received transvaginal surgical treatments. These patients were admitted in our hospital between January 2010 and June 2012.
RESULTS: All surgical treatments were successful without overt complications. The average operation time was 61.5 minutes, the average intraoperative blood loss was 60.5 ml, the average hospital stay was 9.4 days and the average time that blood β-human chorionic gonadotropin (β-HCG) returned to normal range was 15 days. In all 25 patients, the cesarean scar mass located at the anterior wall of the lower uterine segment disappeared by B-ultrasound examination within 1 or 2 weeks after surgery. Postoperatively, the normal menstrual period started again with an average time of 28.9 days. No menstruation-related abnormalities, such as menstrual dripping or an abnormal amount of blood, were reported after surgery.
CONCLUSIONS: Transvaginal surgery for CSP-II is a novel surgical approach. It has several advantages, including a thorough one-time treatment lesion clearance, short operation time, minimized trauma, minimal intraoperative blood loss, quick reduction of blood β-HCG, and rapid menstruation recovery. It is a simple and feasible surgical approach of great clinical value and few treatment-related complications.

Keywords: Blood Loss, Surgical, Adult, Cesarean Section - adverse effects, Chorionic Gonadotropin, beta Subunit, Human - blood, Cicatrix - surgery, Follow-Up Studies, Minimally Invasive Surgical Procedures, operative time, Patient Admission, Postoperative Complications - etiology, Postoperative Period, Pregnancy, Pregnancy, Ectopic - surgery, young adult