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Therapeutic effects of uterine artery embolisation (UAE) and methotrexate (MTX) conservative therapy used in treatment of cesarean scar pregnancy

  • General Gynecology
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Abstract

Purposes

Cesarean scar pregnancy (CSP) is a rare and severe complication after cesarean section. The incidence of CSP has been increased significantly in recent years. In this retrospective case study of 131 CSP patients, the therapeutic effects and prognosis were compared between the two treatment groups: uterine artery embolization and systemic methotrexate injection conservative therapy. In addition, the necessary of subsequent dilation and curettage as a further treatment was also evaluated.

Methods

The 131 CSP patients were assigned into two groups receiving uterine artery embolization (UAE) or MTX conservative therapy. Based on patients’ myometrial thickness and reducing degree of β-hCG level, each of the two treatment group was further divided into two subgroups according to whether the patient received subsequent dilation and curettage as further treatment. The therapeutic effect of two treatment groups was compared.

Results

The results indicated that both UAE and MTX conservative treatment achieved the expected therapeutic effect, and the recovery time in dilation and curettage subgroup was significantly shorter than that of the non-curettage subgroup. One hundred and thirty patients resumed normal menstrual cycles within 3–10 months after the treatment.

Conclusions

The individualized therapeutic regimen is an important factor to achieve the desired therapeutic effect based on the specific indications. Dilation and curettage could shorten the recovery time significantly.

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References

  1. Larsen JV, Solomon MH (1978) Pregnancy in a uterine scar sacculus—an unusual cause of postabortal haemorrhage. A case report. S Afr Med J 53(4):142–143

    CAS  PubMed  Google Scholar 

  2. Arikan Deniz Cemgil, Turgut Emre, Kıran Gürkan et al (2012) Cesarean scar pregnancy treated with methotrexate and dilatation-curettage: case report. Dicle Med J 39(1):102–104

    Article  Google Scholar 

  3. Agarwal N, Shahid A, Odejinmi F (2013) Caesarean scar pregnancy (CSP): a rare case of complete scar dehiscence due to scar ectopic pregnancy and its management. Arch Gynecol Obstet 288(1):231–232

    Article  CAS  PubMed  Google Scholar 

  4. Lumbiganon P, Laopaiboon M, Gülmezoglu AM et al (2010) Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet 375(9713):490–499

    Article  PubMed  Google Scholar 

  5. Fylstra DL (2002) Ectopic pregnancy within a cesarean scar: a review. Obstet Gynecol Surv 57:537–543

    Article  PubMed  Google Scholar 

  6. Ash A, Smith A, Maxwell D (2007) Caesarean scar pregnancy. BJOG 114:253–263

    Article  CAS  PubMed  Google Scholar 

  7. Zhuang Y, Huang L (2009) Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar. Am J Obstet Gynecol 201:152e1–152e3

    Article  Google Scholar 

  8. Coniglio C, Dickinson JE (2004) Pregnancy following prior caesarean scar pregnancy rupture:lessons for modern obstetric practice. Aust N Z J Obstet Gynecol 44:162–166

    Article  Google Scholar 

  9. Zhang Y, Chen YS, Wang JJ et al (2010) Analysis of 96 cases with cesarean scar pregnancy. Chin J Obstet Gynecol 45(9):664–668

    Google Scholar 

  10. Fait G, Goyert G, Sundareson A, Pickens A Jr (1987) Intramural pregnancy with fetal survival: case history and discussion of etiologic factors. Obstet Gynecol 70:472–474

    CAS  PubMed  Google Scholar 

  11. Lian F, Wang Y, Chen W et al (2012) Uterine artery embolization combined with local methotrexate and systemic methotrexate for treatment of cesarean scar pregnancy with different ultrasonographic pattern. Cardiovasc Intervent Radiol 35:286–291

    Article  PubMed  Google Scholar 

  12. Seow KM, Wang PH, Huang LW, Hwang JL (2013) Transvaginal sono-guided aspiration of gestational sac concurrent with a local methotrexate injection for the treatment of unruptured cesarean scar pregnancy. Arch Gynecol Obstet 288(2):361–366

    Article  CAS  PubMed  Google Scholar 

  13. Bignardi T, Condous G (2010) Transrectal ultrasound-guided surgical evacuation of cesarean scar ectopic pregnancy. Ultrasound Obstet Gynecol 35(4):481–485

    Article  CAS  PubMed  Google Scholar 

  14. Maymon R, Halperin R, Mendkovic S et al (2004) Ectopic pregnancy in a caesarean scar. Hum Reprod Update 10:515–523

    Article  CAS  PubMed  Google Scholar 

  15. Rotas MA, Haberman S, Levgur M (2006) Cesarean scar ectopicpregnencies. Obstet Gynecol 107(6):1373–1381

    Article  PubMed  Google Scholar 

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Correspondence to Hua Yang.

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I hereby announce we have no financial relationship with the organization that sponsored the research.

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Yang, H., Li, S., Ma, Z. et al. Therapeutic effects of uterine artery embolisation (UAE) and methotrexate (MTX) conservative therapy used in treatment of cesarean scar pregnancy. Arch Gynecol Obstet 293, 819–823 (2016). https://doi.org/10.1007/s00404-015-3881-0

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  • DOI: https://doi.org/10.1007/s00404-015-3881-0

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