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

ObjectiveTo 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.Methods.Study designA 6-year multicenter retrospective observational cohort study of CSP patients in China.ParticipantsA total of 940 women with endogenous CSP underwent vacuum aspiration surgery (VAS), hysteroscopic conservative surgery (HCS), and excisional surgery (ES).Main outcome measuresDetection rate of cesarean scar diverticulum and preoperative-postoperative differences in RMT.ResultsThe 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).ConclusionES helps lower the incidence of cesarean scar diverticulum and improve RMT.