The value of transvaginal sonography in predicting salvage use of laparoscopy for cesarean scar pregnancy

Abstract

The value of transvaginal sonography in predicting salvage use of laparoscopy for cesarean scar pregnancy Yue Li1,† , Yuan Su1,† , Fanxuan Kong2 , Yu Yang1 , Linxue Qian1, * 1Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, 100050 Beijing, China 2Department of Neurosurgery, PLA Strategic Support Force Characteristic Medical Center, 100101 Beijing, China *Correspondence: qianlinxue2002@163.com (Linxue Qian) † These authors contributed equally. DOI:10.31083/j.ceog4806217 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 6 February 2021 Revised: 25 April 2021 Accepted: 6 May 2021 Published: 15 December 2021 Background: To evaluate the efficacy of transvaginal sonography (TVS) in the management of cesarean scar pregnancy (CSP). Methods: In this retrospective study conducted at Beijing Friendship Hospital of Capital Medical University, 142 CSP patients were collected from January 2015 to September 2019. Patients were divided into two groups, laparoscopy use group (Lap) and no laparoscopy use group (non-Lap) determined by the use of laparoscopy. The ultrasound parameters analyzed between these groups included maximal diameter of gestational sac, presence of fetal heartbeat, local myometrial thickness and grading of color Doppler signals. Results: The maximal diameter of gestational sac in the non-Lap and Lap groups was 2.330 ± 0.930 cm and 2.883 ± 0.420 cm respectively, p = 0.007. Local myometrial thickness was 0.25 (0.16) cm vs 0.16 (0.073) cm, p < 0.001. A positive fetal heartbeat and a grade III color Doppler signals were associated with the use of laparoscopy. Conclusions: TVS is beneficial for the effective treatment of women with CSP. Keywords Cesarean scar pregnancy; Ultrasound; Laparoscopy