ObjectiveTo study the clinical curative effect of the injection of methotrexate (MTX) combined with hysteroscopy in the treatment of uterine scar pregnancy. Methods44 patients of uterine scar pregnancy after cesarean were divided into two groups, patients in the group A (24 cases) were treated by the injection of MTX combined with hysteroscopic operation therapy, patients in group B (20 cases) were treated by hysteroscopy alone. The blood loss, hospitalization time, βHCG hemorrhage and the effect rate were analyzed. ResultsIn group A, the bleeding was obviously decreased compared with that of group B after the operation time, so were bleeding, postoperative recovery time of βHCG. Moreover, the hospitalization time and the recovery time in group A were shorter than those of group B (P＜0.05). Pregnancy mass reduced significantly after treatment in group A (t=3.96, P＜0.05), and the mass in group A reduced more than group B significantly (P＜0.01), so did the peripheral blood flow signal. βHCG on the 7th postoperative day was decreased in both groups, and the A group decreased significantly compared with the B group (P＜0.05). Under hysteroscopy, gray yellow villous tissue of old, mixed oil of old blood clot, qualitative hard, and the tight palace wall adhesion, with pathological examination showing degeneration and necrosis of villi were seen at the anterior wall of the uterus. In the group A, the total efficiency was 83.3% (20/24), significantly higher than that in B group 55% (11/20) (P ＜0.05). ConclusionThe injection of MTX combined with hysteroscopy for uterine scar pregnancy was superior to hysteroscopy alone.

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