Comparison of three treatment strategies for cesarean scar pregnancy.
Arch Gynecol Obstet
; 296(2): 383-389, 2017 Aug.
Article
em En
| MEDLINE
| ID: mdl-28634752
ABSTRACT
PURPOSE:
To explore the optimal treatment for cesarean scar pregnancy.METHOD:
In total, 86 women diagnosed with a cesarean scar pregnancy were divided into three groups according to treatment. The human chorionic gonadotrophin (hCG) decline percentage, intraoperative blood loss and success rate were analyzed in Group A [combination of uterine arterial embolization (UAE), local methotrexate (MTX) injection and dilation & curettage (D&C)], Group B (combination of UAE and local MTX injection) and Group C (D&C). Then, the best treatment was carefully analyzed, and recommendations were provided.RESULTS:
The success rate was highest in Group A (97.5%) compared with Group B (76%) and Group C (63.15%). The reduction in hCG was greatest in Group A (86.62%, 44.0-99.97%) compared with group B (67.83%, 18.0-98.03%) and Group C (68.21%, 27.0-93.24%). The intraoperative blood loss was lowest in Group A (44.881, 5-200 ml) compared with Group C (224.737, 10-1000 ml). Additionally, we found that the best time to perform D&C in group A depended on the hCG reduction percentage, and a 35% reduction after UAE and local MTX injection could be used as the indicator to perform D&C.CONCLUSIONS:
The combination of UAE, local MTX injection and D&C for CSP patients is the optimal treatment strategy. A 35% reduction in hCG after UAE and local MTX injection can be recommended as the indicator to perform D&C.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Gravidez Ectópica
/
Cicatriz
/
Aborto Induzido
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article