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Risk factors for intraoperative hemorrhage at evacuation of a cesarean scar pregnancy following uterine artery embolization.
Wang, Jian-Hua; Qian, Zhi-Da; Zhuang, Ya-Ling; Du, Yong-Jiang; Zhu, Lin-Hua; Huang, Li-Li.
Affiliation
  • Wang JH; Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Int J Gynaecol Obstet ; 123(3): 240-3, 2013 Dec.
Article in En | MEDLINE | ID: mdl-24054055
ABSTRACT

OBJECTIVE:

To determine risk factors associated with massive uterine bleeding during dilation and suction curettage (D&C) after uterine artery embolization (UAE) for the treatment of cesarean scar pregnancy (CSP).

METHODS:

Data from 128 CSP patients treated with D&C after UAE were analyzed to assess risk factors associated with massive uterine bleeding (blood loss 500mL or more) during D&C after UAE.

RESULTS:

In total, 15 CSP patients had massive bleeding during D&C after UAE. Univariate analysis showed that a greater gestational age (GA), a larger CSP mass size, a thinner myometrium at the implantation site, a GA of 8weeks or more, a CSP mass diameter of 6cm or more, and evidence of fetal heartbeat were risk factors for massive bleeding (P<0.05). In a binary logistic regression analysis, GA of 8weeks or more and CSP mass diameter of 6cm or more remained as the only significant risk factors for massive bleeding (OR 11.49 [95% CI 1.08-122.13] and OR 96.59 [95% CI 6.20-150.57], respectively; P<0.05).

CONCLUSION:

For CSP masses with a GA of 8weeks or more and a diameter of 6cm or more, the outcome of surgical evacuation after UAE tends to be unsatisfactory.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pregnancy, Ectopic / Uterine Hemorrhage / Dilatation and Curettage / Uterine Artery Embolization Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Middle aged / Pregnancy Language: En Journal: Int J Gynaecol Obstet Year: 2013 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pregnancy, Ectopic / Uterine Hemorrhage / Dilatation and Curettage / Uterine Artery Embolization Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Middle aged / Pregnancy Language: En Journal: Int J Gynaecol Obstet Year: 2013 Document type: Article Affiliation country: