To investigate the diagnostic value of transabdominal and transvaginal ultrasonography combined with serum human chorionic gonadotrophin-β(β-HCG)detection in cesarean scar pregnancy(CSP).

A total of 80 suspected CSP patients from January 2017 to December 2020 in the 901th Hospital of the Joint Service Support Force of the Chinese People′s Liberation Army were selected as the research objects.CSP and non-CSP were confirmed by pathology.All patients were examined by transabdominal and transvaginal ultrasound and serumβ-HCG detection.The diagnostic values of transabdominal ultrasound, transvaginal ultrasound and two ultrasound methods combined withβ-HCG detection in CSP were compared.

Among the 80 suspected CSP patients, 58 patients were diagnosed as CSP and 22 patients were diagnosed as non-CSP(13 cases of tubal pregnancy, 6 cases of threatened abortion and 3 cases of hysteromyoma)after surgery or pathological examination.The detection rates of transvaginal ultrasound were significantly higher than those of transabdominal ultrasound in muscle thinning, peripheral tissue high-speed low resistance signal, blood flow signs and other signs at the implantation site(P<0.05).The increase ofβ-HCG in CSP patients was significantly lower than that in non-CSP patients(P<0.05).Compared with the results of surgery and pathology, the Kappa values of transabdominal ultrasound, transvaginal ultrasound and two kinds of ultrasound combined with serumβ-HCG were 0.77, 0.84 and 0.90, respectively(P<0.05).The diagnostic rate of the combined diagnostic method was the highest(98.28%).The sensitivity, specificity and accuracy of the combined diagnostic method were 98.28%, 100% and 98.75%, which were all at a high level and higher than those of single transabdominal or transvaginal ultrasound examination.The area under the ROC curve of combined diagnosis was 0.850, which was higher than that of single transabdominal or transvaginal ultrasound.

The combination of transabdominal and transvaginal ultrasonography and serumβ-HCG detection in the diagnosis of CSP has a good consistency with the results of surgery and pathological tissue, and has a high diagnostic accuracy, which can reduce the misdiagnosis and missed diagnosis rate of CSP.