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Risk factors for intraoperative hemorrhage at evacuation of a cesarean scar pregnancy following uterine artery embolization
Author(s) -
Wang JianHua,
Qian ZhiDa,
Zhuang YaLing,
Du YongJiang,
Zhu LinHua,
Huang LiLi
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.06.029
Subject(s) - medicine , uterine artery , gestational age , uterine artery embolization , univariate analysis , surgery , pregnancy , embolization , curettage , dilation and curettage , obstetrics , gestation , multivariate analysis , abortion , genetics , biology
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 500 mL 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 8 weeks or more, a CSP mass diameter of 6 cm or more, and evidence of fetal heartbeat were risk factors for massive bleeding ( P < 0.05). In a binary logistic regression analysis, GA of 8 weeks or more and CSP mass diameter of 6 cm 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 8 weeks or more and a diameter of 6 cm or more, the outcome of surgical evacuation after UAE tends to be unsatisfactory.