Xiaoyi Xiao1, Zhichao Feng1, Ting Li1, Bin Yi2, Shengwang Zhang1, Wei Wang3. 1. Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China. 2. Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. 3. Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China. cjr.wangwei@vip.163.com.
Abstract
INTRODUCTION: High-intensity focused ultrasound (HIFU) followed by curettage and uterine artery embolization (UAE) followed by curettage are two methods of treatment for caesarean scar pregnancy (CSP). There is currently no consistent evidence concerning any difference in efficacy and safety between UAE and HIFU. Therefore, a meta-analysis was performed to compare the efficacy and safety of HIFU and UAE in the treatment of CSP. METHODS: Studies published in PubMed, Cochrane, Embase, Web of Science, Chinese BioMedical Literature Service System, and Chinese National Knowledge Infrastructure databases were searched and the main outcomes in the studies were extracted. RESULTS: Of 8 studies and 715 patients included in this study, 388 and 327 patients were in the HIFU group and UAE groups, respectively. Compared with the UAE group, patients in the HIFU group had less blood loss [weighted mean difference (WMD) = - 22.58 ml; 95% confidence interval (CI) - 44.45 to - 0.70; p < 0.05), lower incidence of adverse events [odds ratio (OR) = 0.17; 95% CI 0.06-0.46; p < 0.05); shorter duration of hospital stay (WMD = - 0.96 days; 95% CI - 1.88 to - 0.03; p < 0.05); and a longer β-human chorionic gonadotropin normalisation time (WMD = 9.59 days; 95% CI 1.66-17.52; p < 0.05). CONCLUSION: Patients in the HIFU group appeared to have better outcomes than those in the UAE group; thus, HIFU may be a priority option for the early management of CSP. However, this needs to be confirmed by multi-centre, large-scale randomised controlled trials.
INTRODUCTION: High-intensity focused ultrasound (HIFU) followed by curettage and uterine artery embolization (UAE) followed by curettage are two methods of treatment for caesarean scar pregnancy (CSP). There is currently no consistent evidence concerning any difference in efficacy and safety between UAE and HIFU. Therefore, a meta-analysis was performed to compare the efficacy and safety of HIFU and UAE in the treatment of CSP. METHODS: Studies published in PubMed, Cochrane, Embase, Web of Science, Chinese BioMedical Literature Service System, and Chinese National Knowledge Infrastructure databases were searched and the main outcomes in the studies were extracted. RESULTS: Of 8 studies and 715 patients included in this study, 388 and 327 patients were in the HIFU group and UAE groups, respectively. Compared with the UAE group, patients in the HIFU group had less blood loss [weighted mean difference (WMD) = - 22.58 ml; 95% confidence interval (CI) - 44.45 to - 0.70; p < 0.05), lower incidence of adverse events [odds ratio (OR) = 0.17; 95% CI 0.06-0.46; p < 0.05); shorter duration of hospital stay (WMD = - 0.96 days; 95% CI - 1.88 to - 0.03; p < 0.05); and a longer β-human chorionic gonadotropin normalisation time (WMD = 9.59 days; 95% CI 1.66-17.52; p < 0.05). CONCLUSION:Patients in the HIFU group appeared to have better outcomes than those in the UAE group; thus, HIFU may be a priority option for the early management of CSP. However, this needs to be confirmed by multi-centre, large-scale randomised controlled trials.
Entities:
Keywords:
Caesarean scar pregnancy; Ectopic pregnancy; Efficacy and safety; High intensity focused ultrasound; Meta-analysis; Uterine artery embolization; Women’s health