Yanli Li1, Liyan Gong1, Xufeng Wu1, Han Gao2, Hongbing Zheng3, Weishun Lan1. 1. Maternal and Child Health Hospital of Hubei Province, Wuhan, China. 2. Maternal and Child Health Hospital of Hubei Province, Wuhan, China. Electronic address: 52109123@qq.com. 3. Department of Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Abstract
OBJECTIVE: To compare the complication rates after uterine artery chemoembolization (UACE) followed by dilation and curettage (D&C) guided by different types of monitoring for treatment of cesarean scar pregnancy (CSP). METHODS: A randomized controlled trial was undertaken of women with CSP attending a hospital in Wuhan, China, between June 1, 2010, and June 30, 2014. Using sealed opaque envelopes containing random numbers, participants were randomly allocated to undergo D&C with hysteroscopy monitoring, ultrasonography monitoring, or no monitoring. Participants and investigators were masked to group assignment. The primary outcome was the number of participants with complications at 2 months of follow-up after D&C. Analyses were by intention to treat. RESULTS: Among 144 participants, 48 were assigned to hysteroscopy monitoring, 44 to ultrasonography monitoring, and 52 to no monitoring. Complications were noted for 1 (2.1%) patient in the hysteroscopy group, 2 (4.5%) in the ultrasonography group, and 12 (23.1%) in the no monitoring group (P=0.001). CONCLUSION: Hysteroscopy or ultrasonography monitoring of D&C after UACE for CSP treatment can decrease the complication rate. ClinicalTrials.gov: NCT02357095.
RCT Entities:
OBJECTIVE: To compare the complication rates after uterine artery chemoembolization (UACE) followed by dilation and curettage (D&C) guided by different types of monitoring for treatment of cesarean scar pregnancy (CSP). METHODS: A randomized controlled trial was undertaken of women with CSP attending a hospital in Wuhan, China, between June 1, 2010, and June 30, 2014. Using sealed opaque envelopes containing random numbers, participants were randomly allocated to undergo D&C with hysteroscopy monitoring, ultrasonography monitoring, or no monitoring. Participants and investigators were masked to group assignment. The primary outcome was the number of participants with complications at 2 months of follow-up after D&C. Analyses were by intention to treat. RESULTS: Among 144 participants, 48 were assigned to hysteroscopy monitoring, 44 to ultrasonography monitoring, and 52 to no monitoring. Complications were noted for 1 (2.1%) patient in the hysteroscopy group, 2 (4.5%) in the ultrasonography group, and 12 (23.1%) in the no monitoring group (P=0.001). CONCLUSION: Hysteroscopy or ultrasonography monitoring of D&C after UACE for CSP treatment can decrease the complication rate. ClinicalTrials.gov: NCT02357095.