Impact of early postoperative human chorionic gonadotropin change direction after high-intensity focused ultrasound on ultrasound-guided dilation and curettage outcomes in cesarean scar pregnancy: a retrospective study.
The direction of β-hCG change after HIFU does not appear to reliably predict outcomes in ultrasound-guided dilation and curettage for cesarean scar pregnancy.
Where it sits
this study against the rest of the hcg (human chorionic gonadotropin) corpusSummary and findings
This study assessed the impact of serum β-hCG changes after high-intensity focused ultrasound (HIFU) on outcomes of ultrasound-guided dilation and curettage (USg-D&C) in 210 patients with cesarean scar pregnancy (CSP). Patients were divided into two groups based on β-hCG direction: declining (n=75) and rising (n=135). No significant differences in procedural outcomes were found between the groups.
Abstract
Objective To assess whether the changing direction of serum β-subunit of human chorionic gonadotropin (β-hCG) after high-intensity focused ultrasound (HIFU) and before ultrasound-guided dilation and curettage (USg-D&C) influences procedural safety and outcome in caesarean scar pregnancy (CSP). Methods This retrospective study was conducted at Deyang People's Hospital, Deyang, China. A total of 210 patients with cesarean scar pregnancy (CSP) were enrolled and divided into two groups based on the direction of serum β-hCG change after HIFU: the hCG declining group (n = 75) and the hCG rising group (n = 135). Baseline features, sonication parameters, blood loss, use of adjuvant haemostasis, re-intervention rate and time to β-hCG normalisation were compared. Results No significant differences were found in baseline data or HIFU parameters between groups. β-hCG on post-curettage day 1 remained higher in the rising group (p < 0.05), yet the percentage drop from post-HIFU value was similar in two groups (p > 0.05). Median intra-curettage blood loss (10 vs 20 mL), adjuvant haemostatic procedures (4.0% vs 6.7%) and re-intervention (6.7% vs 7.4%) also showed no differences (all p > 0.05). Conclusion In this cohort, a post-HIFU rise or fall in β-hCG was not associated with differences in USg-D&C procedure, blood loss or re-intervention. These findings do not establish equivalence, but suggest that short-term β-hCG direction alone may not be a reliable predictor of procedural outcomes.
Background
Not reported in abstract.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Limitations
Not reported in abstract.