LvFen Gao1, Zhongwei Huang2, Jie Gao3, Haoshan Mai1, Yiting Zhang1, Xiaoyu Wang4. 1. Department of Gynecology and Obstetrics, The First Affiliated Hospital of Jinan University, Guangzhou, China. 2. Department of Obstetrics and Gynecology, National University Health Systems, Singapore. 3. Department of Gynecology and Obstetrics, Shenzhen Women's and Children's Hospital, Shenzhen, China. 4. Department of Gynecology and Obstetrics, The First Affiliated Hospital of Jinan University, Guangzhou, China. Electronic address: freshlucy07@126.com.
Abstract
OBJECTIVE: To assess the efficacy of uterine artery embolization (UAE) combined with dilation and curettage (D&C) within 24 hours for the treatment of a cesarean scar pregnancy (CSP), compared with methotrexate and D&C. METHODS: A retrospective cohort study of 119 women with CSP was conducted at two tertiary hospitals in Guangzhou and Shenzhen, China, during 2009-2012. Twenty-six women received systemic methotrexate followed by D&C, and 93 women were treated with UAE followed by D&C within 24 hours. RESULTS: Mean blood loss was 261.0±357.4 mL in the methotrexate group versus 14.1±40.6 mL in the UAE group (P<0.001). The time to resolution of the level of β-human chorionic gonadotropin was 40.5±17.2 days versus 15.4±7.7 days (P<0.001), respectively. The duration of hospitalization was 14.6±9.2 days versus 6.2±3.7 days (P<0.001), respectively. An additional intervention was needed in 9 (35%) women in the methotrexate group and in 5 (5%) in the UAE group (P<0.001). CONCLUSION: UAE combined with D&C within 24 hours was an effective uterine preservation treatment for CSP, and was associated with less blood loss and a shorter hospital stay than administration of methotrexate followed by D&C.
OBJECTIVE: To assess the efficacy of uterine artery embolization (UAE) combined with dilation and curettage (D&C) within 24 hours for the treatment of a cesarean scar pregnancy (CSP), compared with methotrexate and D&C. METHODS: A retrospective cohort study of 119 women with CSP was conducted at two tertiary hospitals in Guangzhou and Shenzhen, China, during 2009-2012. Twenty-six women received systemic methotrexate followed by D&C, and 93 women were treated with UAE followed by D&C within 24 hours. RESULTS: Mean blood loss was 261.0±357.4 mL in the methotrexate group versus 14.1±40.6 mL in the UAE group (P<0.001). The time to resolution of the level of β-human chorionic gonadotropin was 40.5±17.2 days versus 15.4±7.7 days (P<0.001), respectively. The duration of hospitalization was 14.6±9.2 days versus 6.2±3.7 days (P<0.001), respectively. An additional intervention was needed in 9 (35%) women in the methotrexate group and in 5 (5%) in the UAE group (P<0.001). CONCLUSION: UAE combined with D&C within 24 hours was an effective uterine preservation treatment for CSP, and was associated with less blood loss and a shorter hospital stay than administration of methotrexate followed by D&C.