Amartuvshin Tumenjargal1,2, Hiroyuki Tokue3, Hiroshi Kishi4, Hiromi Hirasawa1, Ayako Taketomi-Takahashi1, Yoshito Tsushima1. 1. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan. 2. Department of Obstetrics and Gynecology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia. 3. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan. tokue@s2.dion.ne.jp. 4. Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 371-8511, Japan.
Abstract
PURPOSE: To investigate the efficacy and safety of uterine artery embolization (UAE) followed by dilation and curettage (D&C) as a treatment for cesarean scar pregnancy (CSP) and to assess pregnancy outcomes after the treatment. MATERIALS AND METHODS: We retrospectively analyzed 33 CSP patients treated with UAE followed by D&C. The serum level of beta human chorionic gonadotropin (β-hCG) normalization, hospitalization, menstruation, and successful pregnancy after treatment was assessed as clinical and pregnancy outcomes. RESULTS: A total of 33 patients were initially treated without severe complications. However, four patients required additional systemic chemotherapy. β-hCG normalization took 35.5 ± 14.9 days (range 13-79), and the hospitalization was 6.5 ± 2.5 days (2-15). All patients resumed normal menstruation after 36 ± 19.2 days (12-86). Of 16 of 33 patients who desired pregnancy after the treatment, seven patients (43.8%) had uneventful parturition. CONCLUSIONS: UAE combined with D&C was efficient and safe for CSP management. This minimally invasive procedure may be considered as one of the treatment options which enable preservation of fertility after treatment.
PURPOSE: To investigate the efficacy and safety of uterine artery embolization (UAE) followed by dilation and curettage (D&C) as a treatment for cesarean scar pregnancy (CSP) and to assess pregnancy outcomes after the treatment. MATERIALS AND METHODS: We retrospectively analyzed 33 CSP patients treated with UAE followed by D&C. The serum level of beta human chorionic gonadotropin (β-hCG) normalization, hospitalization, menstruation, and successful pregnancy after treatment was assessed as clinical and pregnancy outcomes. RESULTS: A total of 33 patients were initially treated without severe complications. However, four patients required additional systemic chemotherapy. β-hCG normalization took 35.5 ± 14.9 days (range 13-79), and the hospitalization was 6.5 ± 2.5 days (2-15). All patients resumed normal menstruation after 36 ± 19.2 days (12-86). Of 16 of 33 patients who desired pregnancy after the treatment, seven patients (43.8%) had uneventful parturition. CONCLUSIONS: UAE combined with D&C was efficient and safe for CSP management. This minimally invasive procedure may be considered as one of the treatment options which enable preservation of fertility after treatment.
Authors: Krzysztof Pyra; Maciej Szmygin; Viktor Bérczi; Maria Tsitskari; Michał Sojka; Grzegorz Pietras; Sławomir Woźniak Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-11-09 Impact factor: 1.195