AIM: Cesarean scar pregnancy (CSP) is a rare occurrence of ectopic pregnancy. CSP incidence has increased significantly as a result of the increase in cesarean section rates. At present, there are no standard treatment guidelines for CSP; therefore, we report a minimally invasive treatment method for patients diagnosed with CSP. METHODS: This study included 15 women who were diagnosed with CSP. Ultrasound-guided suction curettage was performed on all patients. The Cook Cervical Ripening Balloon was used to tamponade and prevent hemorrhage during the procedure. In 12 patients, the balloon was placed immediately following ultrasound-guided suction curettage; in two patients, the balloon was placed when excessive bleeding occurred post-curettage; and in one patient, the balloon was placed after the gestational sac evacuated by itself, and then suction aspiration was performed on day 5, following the evacuation. Human chorionic gonadotropin levels were evaluated three days after the procedure. RESULTS: Placement and inflation of the Cook Cervical Ripening Balloon was well tolerated by all patients. The balloon tamponade effectively reduced or prevented vaginal bleeding in all patients, and none of the patients had an estimated blood loss higher than 1000 ml. CONCLUSIONS: Ultrasound-guided suction curettage is effective in the treatment of CSP. The Cook Cervical Ripening Balloon is easy to place and inflate and successfully prevented bleeding or assisted in the management of bleeding complications. We recommend the Cook Cervical Ripening Balloon as an adjuvant method for ultrasound-guided suction curettage for the treatment of CSP.
AIM: Cesarean scar pregnancy (CSP) is a rare occurrence of ectopic pregnancy. CSP incidence has increased significantly as a result of the increase in cesarean section rates. At present, there are no standard treatment guidelines for CSP; therefore, we report a minimally invasive treatment method for patients diagnosed with CSP. METHODS: This study included 15 women who were diagnosed with CSP. Ultrasound-guided suction curettage was performed on all patients. The Cook Cervical Ripening Balloon was used to tamponade and prevent hemorrhage during the procedure. In 12 patients, the balloon was placed immediately following ultrasound-guided suction curettage; in two patients, the balloon was placed when excessive bleeding occurred post-curettage; and in one patient, the balloon was placed after the gestational sac evacuated by itself, and then suction aspiration was performed on day 5, following the evacuation. Human chorionic gonadotropin levels were evaluated three days after the procedure. RESULTS: Placement and inflation of the Cook Cervical Ripening Balloon was well tolerated by all patients. The balloon tamponade effectively reduced or prevented vaginal bleeding in all patients, and none of the patients had an estimated blood loss higher than 1000 ml. CONCLUSIONS: Ultrasound-guided suction curettage is effective in the treatment of CSP. The Cook Cervical Ripening Balloon is easy to place and inflate and successfully prevented bleeding or assisted in the management of bleeding complications. We recommend the Cook Cervical Ripening Balloon as an adjuvant method for ultrasound-guided suction curettage for the treatment of CSP.
Authors: Karen Grewal; Benjamin Jones; Ariadne L'Heveder; Sita Jindal; Nicolas Galazis; Srdjan Saso; Joseph Yazbek Journal: Future Sci OA Date: 2021-01-12