The effect of prophylactic uterine artery embolization on reproductive outcomes in patients with cesarean scar pregnancy: a propensity score-matched study

PURPOSE This study aimed to investigate the effect of prophylactic uterine artery embolization (UAE) on reproductive outcomes in patients with cesarean scar pregnancy (CSP). METHODS A retrospective case-control study was conducted using the hospital records of all women diagnosed with CSP during a period of 6 years, between January 2014 and December 2019, at Shengjing Hospital of China Medical University. The clinical characteristics and different treatment modalities were analyzed. According to the inclusion and exclusion criteria, 181 patients with reproductive needs were selected and divided into a UAE group (n = 51) and a non-UAE group (n = 130) according to whether they received preventive UAE before their hysteroscopic or laparoscopic operation. The basic characteristics and pregnancy outcomes of patients in each group were compared, and a propensity score-matched (PSM) analysis was used to produce 37 matched pairs. RESULTS Before PSM, the UAE group had a thinner muscle layer, larger mass size, and higher serum human chorionic gonadotropin level than the non-UAE group. The pregnancy rate and live birth rate of the UAE group were 54.9% and 61.9%, respectively, which were lower than those of the non-UAE group (61.5% and 66.7%), but no statistical differences were observed. Post-PSM, no significant differences between basic characteristics of the groups were observed. The pregnancy rate of the UAE group was 51.4%, which was lower than that of the non-UAE group (73.0%); the live birth rate of the UAE group was 64.3%, which was also lower than that of the non-UAE group (72.7%); however, the differences were not statistically significant with the P value of 0.077 and 0.716. CONCLUSION Prophylactic UAE did not induce a significant difference in pregnancy rate and live birth rate between the UAE group and the non-UAE group.