Management of Cesarean Scar Pregnancy Using Ultrasound-Guided Dilation and Curettage.
J Minim Invasive Gynecol
; 23(5): 707-11, 2016.
Article
em En
| MEDLINE
| ID: mdl-26803916
ABSTRACT
STUDY OBJECTIVE:
To evaluate the potential risk factors associated with failed ultrasound-guided dilation and curettage (D&C) treatment of cesarean scar pregnancy (CSP).DESIGN:
Retrospective study.SETTING:
University hospital. PATIENTS Fifty-one patients diagnosed with CSP and treated with ultrasound-guided D&C at Shanghai General Hospital of Shanghai Jiao Tong University. INTERVENTION Lesion resection using ultrasound-guided D&C. MEASUREMENTS AND MAINRESULTS:
Clinical characteristics, vaginal bleeding, abdominal pain, the size of the gestational sac, cardiac motion, blood flow around the gestational sac, cesarean scar thickness, and serum ß-human chorionic gonadotropin (ß-hCG) levels were compared between the successful operation group and the failed operation group. Cesarean scar thickness was the main risk factor that determined the success of ultrasound-guided D&C. The success rates were 50% and 97.67% for those with cesarean scars <3 mm thick and those with scars >3 mm thick, respectively (p = .001). The success rate was also associated with the abundance of blood flow surrounding the capsule and size of the gestational sac (p < .005). Surgical success was not affected by abnormal vaginal bleeding, abdominal pain, cardiac motion, or serum ß-hCG levels.CONCLUSION:
Ultrasound-guided D&C is the first choice for treating CSP if the cesarean scar is >3 mm thick, blood flow is not abundant, and the maximum diameter of the gestational sac is <30 mm. A transabdominal procedure is preferred for patients with high-risk factors.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gravidez Ectópica
/
Cicatriz
/
Cirurgia Assistida por Computador
/
Dilatação e Curetagem
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Minim Invasive Gynecol
Assunto da revista:
GINECOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
China