KẾT QUẢ ĐIỀU TRỊ CHỬA SẸO MỔ LẤY THAI CÓ TĂNG SINH MẠCH BẰNG PHƯƠNG PHÁP NÚT ĐỘNG MẠCH TỬ CUNG KẾT HỢP HÚT THAI DƯỚI HƯỚNG DẪN SIÊU ÂM

Abstract

Objectives: To evaluate the effectiveness of uterine artery embolization (UAE) combined with ultrasound-guided suction curettage in the management of CSP with enhanced myometrial vascularity, and to identify factors related to intra- and post-procedural hemorrhage. Methods: A retrospective descriptive study was conducted on 53 patients diagnosed with CSP showing moderate to severe enhanced myometrial vascularity, treated with UAE followed by ultrasound-guided suction curettage at the National Hospital of Obstetrics and Gynecology between January 2023 and December 2024. Results: The mean gestational age at diagnosis was 8.02 weeks. Most patients were asymptomatic upon admission. Ultrasound findings showed that 52.8% of cases had type 3 gestational sac location, 50.9% exhibited severe vascular enhancement, and 81.1% had a myometrial thickness of less than 2 mm at the implantation site. The overall treatment success rate was 98.1%. Twenty-two patients (41.5%) required intrauterine balloon tamponade to control hemorrhage. Type 3 sac location and severe vascular enhancement were significantly associated with an increased risk of bleeding requiring balloon tamponade (p<0.05). Conclusion: UAE combined with ultrasound-guided suction curettage is a safe and effective treatment option for CSP with enhanced myometrial vascularity.