Clinical analysis of mifepristone combined with transabdominal ultrasound-guided suction and curettage for different types of scar pregnancy

Abstract Background Cesarean scar pregnancy (CSP) is a life-threatening condition without consensus on treatment. The purpose of this study was to evaluate the safety, efficacy, and outcome of mifepristone combined with transabdominal ultrasound-guided suction and curettage (TUSC) in the treatment of CSP. Methods CSP patients who treated with mifepristone combined TUSC at Maternal and Child Hospital of Hubei Province from 2013 to 2015 was retrospectively analyzed. Patients were divides into three types based on the newest classification criteria in China. Clinical information and outcomes were analyzed. Results 157 CSP patients were included, with 96 type I cases, 56 type II cases and 5 type III cases. No significant differences in age, gravity, parity, gestational age and initial β-human chorionic gonadotropin (β-hCG) levels among the three types. All patients were successfully treated with mifepristone combined with TUSC. No one needed emergency blood transfusion or another treatment. After mifepristone combined with TUSC treatment, the percentage changes of the β-hCG levels were similar in all CSP types. The average of intraoperative blood loss in type I patients during suction curettage was lower than in type II and type III, and more Foley catheters were inserted into the uterus in type II and type III than type I patients to achieve hemostasis. Conclusion Mifepristone combined with TUSC appears to be a safety and efficacy treatment option to all types of CSP.