Evaluation of Therapeutic Effect of Resectoscopic Surgery on 90 Cases of Cesarean Scar Pregnancy

Introduction: Although the prevalence of cesarean scar pregnancy (CSP) is rare, its complications can be life threatening. It seems there is a force need for a treatment that has the minimum chance of massive blood loss and injury to the uterus with fertility preservation in these cases. Hence, the current study aimed to evaluate the safety and efficacy of resectoscopic surgery treatment in cesarean scar pregnancy. Methods: : This single-arm interventional study was conducted on 90 patients with the diagnosis of CSP at a tertiary university-based hospital from April 2019 to 2021. Results: : The mean age of patients was 30.90±6.05 years with ranges of 18 to 45. The average gestational age at diagnosis time was 7.27±2.06 weeks and baseline myometrial thickness mean was 1.46±0.56 mm. In near half of the cases, the baseline β-hCG was lower than 10000 IU/ml. About 48 hours after study intervention, the β-hCG mean level decreased significantly (p-value=0.009), 34965.97±104670.23 to 6264.12±8622.93 IU/ml. For all patients except two, at least a 30% decline in baseline β-hCG was reached, and in most cases, this decrease was more than 50%. Although the Hb mean level decreased significantly (p-value<0.001) after study intervention, 12.87±1.63 to 11.27±1.88 g/dL, this decline was lower than 50% in all study patients, and in half of cases it was less than 10%. Conclusion: It seems resectoscopy, in patients with CSP, can rapidly reduce serum β-hCG concentration without any significant blood loss or organ injury, as well as decline hospital stay length; hence, it may be suggested as a safe, non-expensive strategy in CSP management.