Abstract: Objective  To study the relationship between ultrasound image characteristics of cesarean scar pregnancy(CSP) and clinical diagnosis and treatment plan. 
Methods  A retrospective analysis was performed on 38 patients of CSP receiving treatment in the Third Hospital of Hebei Medical University.Different diagnosis and treatment plans were selected on the basis of ultrasonic classification, and its clinical data, diagnosis and treatment plans, and outcomes were analyzed. 
Results  ①All 38 cases were divided into 3 groups, including 14 cases of typeⅠin group one(5.00-9.10 weeks of gestation, 2 cases ≥8 weeks),12 cases of type Ⅱ(5.60-8.40 weeks of gestation) in group two, and 12 cases of type Ⅲ(7.60-9.00 weeks of gestation) in group 3. ②All the patients underwent surgery successfully based on the ultrasonic classification. At one day after surgery,β-human chorionic gonadotropin(β-HCG) levels fell to less than 50% of that before surgery for all the patients. After three months, the sonography of all patients showed no abnormal echo in the lower segment of anterior uterine wall. ③As for duration of operation and blood loss, the median level of blood loss during the procedure was 17.50(40.00) mL of  typeⅠand 20.00(90.00) mL of typeⅠ(more than 8 weeks) and type Ⅱ. The median level of blood loss during the procedure was 100.00(250.00) mL of type Ⅲ. The average of operation duration was(10.42±1.44) min for typeⅠ, (11.92±3.84) min for typeⅡ， and(96.15±39.43) min for  type Ⅲ,suggesting significant differences between groups(P＜0.05).β-HCG fell to normal levels, and the length of hospital stay and the myometrium thickness after operation were better in the laparoscopic surgery group than in curettage group, suggesting significant difference(P＜0.05). 
Conclusion  Preciseultrasonic classification and positioning inspections provide an important basis for the selection of clinical diagnosis and treatment options, which is conducive to individualized diagnosis and treatment according to the specific conditions of patients. Laparoscopic CSP removal of pregnancy products and uterine scar repair have the advantages of high success rate, small trauma and short hospitalization while preserving the patient′s fertility function. They can be the first choice for the treatment of type Ⅲ and some type Ⅱ cases.

Key words: pregnancy, cicatrix, cesarean section, ultrasonography