Cesarean scar pregnancy (CSP) is an uncommon and potentially life-threatening form of ectopic pregnancy characterized by embryo implantation within the scar tissue of a prior cesarean delivery. The aim of this study is to compare clinical outcomes between focused ultrasound ablation surgery (FUAS) combined with suction curettage under hysteroscopic guidance and transvaginal debridement and repair surgery (TDRS) in the treatment of CSP. A retrospective analysis was conducted on 78 patients with CSP and treated between 2017 and 2023. Among them, 25 received FUAS followed by hysteroscopic suction curettage, and 53 underwent TDRS. Key clinical indicators included intraoperative parameters, postoperative recovery, treatment costs, complications, and subsequent pregnancy outcomes. No significant differences were observed between the two groups in terms of intraoperative blood loss, decline rates of β-human chorionic gonadotropin and hemoglobin, or menstrual recovery. FUAS was associated with a significantly shorter operative time (34.96 ± 28.90 vs 60.13 ± 22.87 minutes, p 0.05). No procedure-related complications were reported in either group. Both FUAS combined with curettage and TDRS demonstrated safety and effectiveness in the treatment of CSP, with favorable post-treatment fertility outcomes. TDRS was associated with shorter hospitalization and lower medical costs and may be preferable for certain CSP subtypes, such as type III. Treatment selection should be individualized based on clinical characteristics.
Feng et al. (Fri,) studied this question.