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Uterine artery embolization followed by dilation and curettage within 24 hours compared with systemic methotrexate for cesarean scar pregnancy
Author(s) -
Gao LvFen,
Huang Zhongwei,
Gao Jie,
Mai Haoshan,
Zhang Yiting,
Wang Xiaoyu
Publication year - 2014
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.2014.05.005
Subject(s) - medicine , methotrexate , dilation and curettage , uterine artery embolization , curettage , uterine artery , human chorionic gonadotropin , pregnancy , surgery , blood loss , retrospective cohort study , obstetrics , embolization , anesthesia , abortion , gestation , biology , hormone , genetics
Objective To assess the efficacy of uterine artery embolization (UAE) combined with dilation and curettage (D&C) within 24 hours for the treatment of a cesarean scar pregnancy (CSP), compared with methotrexate and D&C. Methods A retrospective cohort study of 119 women with CSP was conducted at two tertiary hospitals in Guangzhou and Shenzhen, China, during 2009–2012. Twenty‐six women received systemic methotrexate followed by D&C, and 93 women were treated with UAE followed by D&C within 24 hours. Results Mean blood loss was 261.0 ± 357.4 mL in the methotrexate group versus 14.1 ± 40.6 mL in the UAE group ( P < 0.001). The time to resolution of the level of β‐human chorionic gonadotropin was 40.5 ± 17.2 days versus 15.4 ± 7.7 days ( P < 0.001), respectively. The duration of hospitalization was 14.6 ± 9.2 days versus 6.2 ± 3.7 days ( P < 0.001), respectively. An additional intervention was needed in 9 (35%) women in the methotrexate group and in 5 (5%) in the UAE group ( P < 0.001). Conclusion UAE combined with D&C within 24 hours was an effective uterine preservation treatment for CSP, and was associated with less blood loss and a shorter hospital stay than administration of methotrexate followed by D&C.