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Background: This study aimed to evaluate the effectiveness of different treatments for cesarean scar pregnancy (CSP) and to identify key factors influencing treatment selection, in order to help standardize CSP management. Methods: We retrospectively analyzed data from 220 CSP patients at the Family Planning Department of the Women's Hospital, School of Medicine, Zhejiang University, from January 2019 to December 2019, adhering to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. Treatment methods included dilation and curettage (D&C), curettage after uterine artery embolization (UAE+C), hysteroscopy plus curettage (H/S+C), H/S+C following UAE (UAE+H/S+C), and hysteroscopy combined with laparoscopic resection (L/S+H/S). We assessed treatment outcomes by evaluating the normalization of serum β-human chorionic gonadotropin (β-hCG) levels, disappearance of the isthmic mass, and the occurrence of complications. Results: No significant difference in treatment success rates was found among the groups (p > 0.05). Larger gestational sac diameter (GSD) and thinner myometrial thickness were significant factors in choosing uterine artery embolization (UAE) (p < 0.05), while thinner myometrial thickness alone was a predictor for selecting H/S+C (p < 0.05). The presence of a fetal heartbeat and the subtype of CSP also influenced the choice of UAE and surgical treatment (p < 0.05). Conclusions: This study highlights the need for personalized treatment plans for CSP, considering factors like GSD, myometrial thickness, heartbeat, and CSP subtype. Although no treatment method proved superior, the study identifies important considerations for treatment selection, emphasizing the importance of individualized care in CSP management. The use of STROBE guidelines ensured comprehensive reporting and analysis, offering valuable insights for CSP treatment.
Niu et al. (Tue,) studied this question.