This study aimed to investigate the efcacy of hysteroscopic surgery for endogenous cesarean scar pregnancy (CSP) and the value of prophylactic ultrasound-guided local injection of lauromacrogol.

Design:

This retrospective cohort study included 131 patients diagnosed with endogenous CSP who underwent hysteroscopic surgery at the Hangzhou Fuyang Women and Children Hospital between January 2018 and May 2022. Lauromacrogol (10–20 mL) was administered within 24 h preoperatively using an ultrasound-guided vaginal injection to 78 patients (L group) versus not administered to 53 patients (non-L group). Their clinical data and outcomes were analyzed.

Setting:

A minimally invasive gynecology department of a public tertiary hospital.

Patients or Participants:

Patients with endogenous cesarean scar pregnancy treated by hysteroscopic surgery.

Interventions:

Prophylactic lauromacrogol injection.

Measurements and Main Results:

Mean gestational age, gestational mass size, and uterine scar thickness and median preoperative blood β-human chorionic gonadotropin levels of the non-L versus L groups were 46.26 versus 45.01 days, 2.05 versus 2.39 cm, 0.35 versus 0.32 cm, and 19850.0 versus 26790.0 U/L, respectively (P>0.05 for each). The non-L and L groups had similar success rates (98.1% vs. 98.7%, P=1.0). Complications related to lauromacrogol administration, including abdominal pain, massive bleeding, and bradycardia, were experienced by 46.2% (36/78; P<0.001) of L group patients. The non-L had a signifcantly shorter mean hospital stay (4.85±1.12 vs 5.44±1.08 days) and lower total cost (6148.75±1028.71 vs 9016.61±1181.19 yuan) (P<0.01).

Conclusion:

Hysteroscopic surgery is efective and safe for patients with endogenous CSP. Prophylactic lauromacrogol injection increases the incidence of complications and costs. Direct hysteroscopic surgery can reduce pain and fnancial burden in patients with endogenous CSP and save medical resources for other patients.