Evaluation of the efficacy of laparoscopic resection for the management of exogenous cesarean scar pregnancy

Objective: To retrospectively analyze the clinical data of 71 patients with exogenous cesarean scar pregnancy (CSP) treated in our hospital in the past 2 years, to compare the outcomes of exogenous CSP treated with different methods, and to evaluate the safety and feasibility of laparoscopic resection of exogenous CSP. Design: Comparative observational study. Setting: Tertiary medical centers. Patient(s): 71 women with exogenous cesarean scar pregnancy. Intervention(s): Hysteroscopic resection of CSP, and laparoscopic resection of CSP. Main Outcome Measure(s): Operation time, intraoperative blood loss, postoperative drainage of the uterine cavity, postoperative days in hospital, time for beta-human chorionic gonadotropin (beta-hCG) to return to normal levels, absorption time of the mass. Result(s): For the laparoscopic group, the time for serum beta-hCG to return normal levels and the postoperative drainage of the uterine cavity were significantly lower than in the patients who had undergone hysteroscopic resection. We found no statistically significant difference in the intraoperative blood loss and postoperative days in hospital between the two groups, but the operation time was longer in laparoscopic group. Conclusion(s): Laparoscopic surgery for a cesarean scar pregnancy has the advantages of a high success rate, fewer complications, and a shorter time for beta-hCG levels to normalize. This procedure is especially suitable for the treatment of exogenous CSP. (C) 2014 by American Society for Reproductive Medicine.