A comparison of high-intensity focused ultrasound and uterine artery embolisation for the management of caesarean scar pregnancy

Purpose: The aim of this study was to retrospectively analyse the clinical data of 122 patients with caesarean scar pregnancy (CSP) treated in our hospital, to compare the outcomes between high-intensity focused ultrasound (HIFU) and uterine artery embolisation (UAE). Materials and methods: Among the 122 patients, 76 patients were treated with HIFU followed by suction curettage under hysteroscopic guidance, 46 patients were treated with UAE followed by suction curettage under hysteroscopic guidance. Pain score, intraoperative blood loss in suction curettage under hysteroscopy guidance, time for vaginal bleeding, beta-human chorionic gonadotropin (beta-hCG) to return to normal level, normal menstruation recovery, hospital stay, and the adverse effects were all compared. Results: No statistically significant differences between the two groups in the intraoperative blood loss, hospital stay, time for beta-human chorionic gonadotropin (beta-hCG) to return to normal level, or time for normal menstruation recovery were observed. The pain score was lower and the adverse effects were fewer in the HIFU group than those in the UAE group. However, the time for vaginal bleeding was longer in the patients treated with HIFU than that of patients treated with UAE. Conclusions: Based on our results, it appears that either HIFU or UAE combined with suction curettage under hysteroscopic guidance is safe and effective in treating patients with CSP. Compared with UAE, HIFU treatment for CSP has the advantages of a lower pain score and fewer adverse effects.