Treatment Outcomes of Excisional Versus Conservative Surgery for Endogenous Cesarean Scar Pregnancy: A Retrospective Cohort Study.

OBJECTIVE: To compare treatment outcomes (including cesarean scar diverticulum and residual myometrium thickness [RMT]), among patients with endogenous cesarean scar pregnancy (CSP) stratified by the Chinese classification. STUDY DESIGN: A 6-year multicenter retrospective observational cohort study of CSP patients in China. PARTICIPANTS: A total of 940 women with endogenous CSP underwent vacuum aspiration surgery (VAS), hysteroscopic conservative surgery (HCS), and excisional surgery (ES). MAIN OUTCOME MEASURES: Detection rate of cesarean scar diverticulum and preoperative-postoperative differences in RMT. RESULTS: The postoperative detection rate of cesarean scar diverticulum was 77.5% (555/716) in the Type 2 CSP group, significantly higher than that of 64.3% (144/224) in the Type 1 CSP group (p < 0.001). The preoperative-postoperative change in RMT was 0.13 ± 0.11 for Type 2 CSP patients, significantly higher compared with -0.10 ± 0.16 in Type 1 CSP patients (p < 0.001). CONCLUSION: ES helps lower the incidence of cesarean scar diverticulum and improve RMT.