Fertility After Transvaginal Surgery or Uterine Artery Embolization Combined With Uterine Curettage in Patients With Cesarean Scar Pregnancy

Study Overview
=================
Brief Summary
-----------------
To investigate the fertility in patients after treatment by transvaginal surgery or uterine artery embolization combined with uterine curettage

Official Title
-----------------
Fertility After Transvaginal Surgery or Uterine Artery Embolization Combined With Uterine Curettage in Patients With Cesarean Scar Pregnancy

Conditions
-----------------
Magnetic Resonance Imaging, Ovarian Function, Menstruation

Intervention / Treatment
-----------------
* Procedure: transvaginal surgery；UAE and D&C


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: increased levels of serum β-hCG and ultrasonography findings. The criteria for diagnosis by ultrasonography was the presence of the following: (1) an empty uterine cavity and endocervical canal; (2) detection of the placenta and/or a gestational sac embedded in the hysterectomy scar; (3) the presence of the gestation sac with or without a fetal pole and with or without fetal cardiac activity (depending on the gestational age) in the anterior part of the uterine isthmus; and (4) a thin (1-3 mm) or absent myometrial layer between the gestational sac and the bladder(24). All patients had taken Magnetic Resonance Imaging (MRI) to clarify the diagnosis . Pregnancy tissues were identified by histopathology examinations of the surgical tissues. Exclusion Criteria: All enrolled patients had no contraindications for transvaginal surgery or UAE, including renal failure, active pelvic infection, clotting disorders, or known allergy to the contrast material.
Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: CSP；transvaginal surgery；UAE and D&C<br>Cesarean scar pregnancy (CSP) refers to the implantation of a gestational sac with the myometrium at the site of a previous cesarean scar | Procedure: transvaginal surgery；UAE and D&C<br>* For cesarean scar pregnancy treatment<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of menstruation by questionnaire (days) |  | six months after treatment | 
| Endocrine level by blood examination (FSH in IU/L) |  | six months after treatment | 
| Volume of menstruation by questionnaire (in pictorial blood loss score) |  | six months after treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The length of the CSD by MRI (millimeter) |  | six months after treatment | 
| The width of the CSD by MRI (millimeter) |  | six months after treatment | 
| The depth of the CSD by MRI (millimeter) |  | six months after treatment |