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Article Open Access

Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy

  • Authors:
    • Ying Feng
    • Suwen Chen
    • Changdong Li
    • Xiaofeng Zhang
    • Hua Duan
    • Suren Sooranna
    • Mark R. Johnson
    • Jian Li
  • View Affiliations / Copyright

    Affiliations: Department of Gynaecology, Beijing Obstetrics and Gynaecology Hospital, Capital Medical University, Beijing 100026, P.R. China, Department of Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London SW10 9NH, UK
    Copyright: © Feng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1469-1475
    |
    Published online on: June 29, 2016
       https://doi.org/10.3892/etm.2016.3489
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Abstract

In the present study, we evaluated the diagnosis and management modalities of caesarean scar pregnancy (CSP). Thirty patients diagnosed with CSP were retrospectively studied between February, 2010 and February, 2012. Twenty-five patients were offered prophylactic uterine artery embolization (UAE) and methotrexate (MTX) prior to uterine suction curettage. Five cases were referred from other hospitals where the initial management with uterine suction curettage had resulted in uncontrollable massive haemorrhage, 4 of the cases had UAE and one proceeded immediately to hysterectomy. In the 25 patients treated with prophylactic UAE and MTX, 12 had laparoscopy-guided curettage and 13 had ultrasound-guided curettage without complication. The results showed that the 25 patients with CSP, who received prophylactic UAE and MTX prior to uterine curettage, recovered without complications. Five patients referred from other hospitals, where uterine curettage was the primary procedure, had severe complications including uncontrolled vaginal bleeding and uterine rupture. Four of the five patients were treated successfully with emergency UAE and the remaining patient underwent emergency hysterectomy as ultrasound examination detected significant haemorrhage between the uterus and the bladder. Of the 25 patients who received prophylactic UAE combined with MTX, there were no reports of irregular menstruation or serious adverse effects. Notably, the decrease in serum human chorionic gonadotropin (HCG) levels 3 days post‑surgery was greater with ultrasound-guided curettage (84.3±5.5%) than with laparoscopy-guided curettage (76.3±10.2%). In summary, the data suggested that prophylactic UAE with MTX followed by ultrasound-guided curettage is the most effective therapeutic approach in CSP.
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Copy and paste a formatted citation
Spandidos Publications style
Feng Y, Chen S, Li C, Zhang X, Duan H, Sooranna S, Johnson MR and Li J: Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy. Exp Ther Med 12: 1469-1475, 2016.
APA
Feng, Y., Chen, S., Li, C., Zhang, X., Duan, H., Sooranna, S. ... Li, J. (2016). Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy. Experimental and Therapeutic Medicine, 12, 1469-1475. https://doi.org/10.3892/etm.2016.3489
MLA
Feng, Y., Chen, S., Li, C., Zhang, X., Duan, H., Sooranna, S., Johnson, M. R., Li, J."Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy". Experimental and Therapeutic Medicine 12.3 (2016): 1469-1475.
Chicago
Feng, Y., Chen, S., Li, C., Zhang, X., Duan, H., Sooranna, S., Johnson, M. R., Li, J."Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy". Experimental and Therapeutic Medicine 12, no. 3 (2016): 1469-1475. https://doi.org/10.3892/etm.2016.3489
Copy and paste a formatted citation
x
Spandidos Publications style
Feng Y, Chen S, Li C, Zhang X, Duan H, Sooranna S, Johnson MR and Li J: Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy. Exp Ther Med 12: 1469-1475, 2016.
APA
Feng, Y., Chen, S., Li, C., Zhang, X., Duan, H., Sooranna, S. ... Li, J. (2016). Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy. Experimental and Therapeutic Medicine, 12, 1469-1475. https://doi.org/10.3892/etm.2016.3489
MLA
Feng, Y., Chen, S., Li, C., Zhang, X., Duan, H., Sooranna, S., Johnson, M. R., Li, J."Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy". Experimental and Therapeutic Medicine 12.3 (2016): 1469-1475.
Chicago
Feng, Y., Chen, S., Li, C., Zhang, X., Duan, H., Sooranna, S., Johnson, M. R., Li, J."Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy". Experimental and Therapeutic Medicine 12, no. 3 (2016): 1469-1475. https://doi.org/10.3892/etm.2016.3489
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