Scar pregnancy intervention surgery, fertility is no longer a problem

Scar pregnancy is extremely harmful and can be life-threatening if not treated in time. The emergence of scar pregnancy intervention surgery not only successfully preserves the uterus, but also reduces the mortality rate and the possibility of various complications, shortens the operation and hospitalization time, and the postoperative effect is relatively ideal.

1. If you get pregnant again after a cesarean section, you should be wary of scar pregnancy

Women with a history of cesarean section should be alert to the possibility of uterine scar pregnancy when they become pregnant again. If irregular vaginal bleeding occurs after menopause, ultrasound or MRI examination should be performed early. When a uterine scar pregnancy is confirmed, it is recommended to terminate the pregnancy as soon as possible to prevent serious complications such as uterine rupture and heavy bleeding.

2. The muscle layer at the scar is weak, so it is not advisable to perform curettage immediately

"Once a uterine scar pregnancy is confirmed, an appropriate treatment plan should be developed based on the location, depth of invasion of the gestational sac into the uterine wall and the lesion, as well as the patient's different requirements for fertility." Experts say that because the muscle layer at the uterine scar is very weak, if the uterus is scraped blindly, there may be fatal bleeding during the curettage due to failure of blood vessels to close. Therefore, it is generally not recommended to perform a curettage immediately.

Some people have suggested conservative treatment with drugs. Although it can avoid unnecessary surgery and preserve the patient's reproductive function, it is time-consuming and the local mass is absorbed slowly. If laparotomy is used, the pregnancy products at the scar can be removed while the cavity or sinus connected to the uterine cavity is cleared, reducing the risk of recurrence. However, the surgery is traumatic and the recovery is slow, so it is not a good solution.

3. It is safer to perform ultrasound curettage 48 hours after interventional treatment

So, is there any way to reduce intraoperative bleeding while meeting the patient's fertility needs?

Experts say that interventional treatment can be considered at present - infusing methotrexate into both uterine arteries and performing bilateral uterine artery embolization at the same time to allow the drug to quickly reach the local gestational sac. On the one hand, it can block the blood supply to the gestational sac and achieve the purpose of quickly killing the embryo. On the other hand, drugs and embolic agents (gelatin sponge) will not damage the fallopian tube wall tissue or interfere with the repair of the tube wall. They can effectively maintain its patency and minimize or prevent fatal massive bleeding caused by rupture of the gestational sac.

48 hours after the interventional treatment, a curettage can be performed under the guidance of B-ultrasound, making the invisible curettage visible, which can greatly reduce the possibility of uterine perforation and incomplete uterine aspiration. The postoperative results are relatively ideal, not only successfully preserving the uterus, but also reducing the mortality rate and the possibility of various complications, and shortening the operation and hospitalization time.