Analysis of the type of cesarean scar pregnancy impacted on the effectiveness and safety of high intensity focused ultrasound combined with ultrasound-guided suction curettage treatment

Peng, Yan; Dai, Yu; Yu, Guiyuan; Park, Jin

doi:10.1080/02656736.2022.2107715

Cited by 11 publications

(18 citation statements)

References 30 publications

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“…Regarding 305 CSP patients who were managed with HIFU‐S/C‐U, the mean and SD of hospital stay was 5.1 ± 2.01 days [20, 23]. Mu and Yuan did not report relevant data [21, 27].…”

Section: Resultsmentioning

confidence: 99%

Curative effect of high‐intensity focused ultrasound in management of different types of ectopic pregnancy: A systematic review

Ali,

Abdelsamad,

Ragab

2024

iRADIOLOGY

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Ectopic pregnancy (EP) could be defined as any embryo that got implanted in any site rather than the endometrial cavity. Lately, different types of EP were reportedly managed by high‐intensity focused ultrasound (HIFU). We aimed to pool all available data in a systematic review without meta‐analysis and investigate the efficacy and safety tendencies of HIFU among different types of EP. We applied our comprehensive terms in Google Scholar, PubMed, Scopus, Ovid, and PubMed Central databases from their inception until September 23. Retrieved references were gathered using EndNote in which we omitted the duplicates and exported the record for screening. Data regarding characteristics, safety and efficacy outcomes, and baseline information of the enrolled population were extracted. The eligible case reports were assessed using a tool by Murad and colleagues, while the quality of the included cohorts was appraised using the NIH tool. We retrieved 6637 studies, which were scrutinized by titles and abstracts. We scrutinized the full texts of 36 studies and ultimately included a total of 17 studies. All studies were conducted in China, and on different types of ectopic pregnancy including tubal, cervical, intramural, caesarian scar, and corneal ectopic pregnancy. The mean age of enrolled patients was 33.03 years, and we pooled a total sample of 853 patients. The follow‐up period varied widely among the included studies, ranging from 1.3 months to up to 69 months. Normal menstruation recurred after a mean of 35 days, as reported by nine studies. Most of the included studies reported normal β‐HCG after around 30–40 days. Twelve studies with 757 patients reported a cumulative incidence of 179 cases of abdominal pain after HIFU. Neither of the enrolled patients reportedly complained of skin burn after HIFU. We suggested managing EP patients with HIFU, especially when seeking further conceiving. High‐quality randomized controlled trials are required to draw a stronger level of evidence.

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“…Regarding 305 CSP patients who were managed with HIFU‐S/C‐U, the mean and SD of hospital stay was 5.1 ± 2.01 days [20, 23]. Mu and Yuan did not report relevant data [21, 27].…”

Section: Resultsmentioning

confidence: 99%

Curative effect of high‐intensity focused ultrasound in management of different types of ectopic pregnancy: A systematic review

Ali,

Abdelsamad,

Ragab

2024

iRADIOLOGY

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“…In the present study, SC was performed using a 4‐5‐6 numbered soft plastic cannula under transabdominal B‐mode ultrasound guidance. The complete ultrasound‐guided SC procedure has been previously described 13 . In brief, the procedure was performed under general anesthesia with ultrasound guidance and patients in the lithotomy position.…”

Section: Methodsmentioning

confidence: 99%

“…The complete ultrasound-guided SC procedure has been previously described. 13 In brief, the procedure was performed under general anesthesia with ultrasound guidance and patients in the lithotomy position. A Sims speculum was inserted into the vagina to visualize the cervix.…”

Section: Suction Curettagementioning

confidence: 99%

Clinical efficacy and risk factors for suction curettage and hysteroscopy in patients with type I and II cesarean scar pregnancy

Wang

Liu

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo investigate the clinical efficacy and evaluate risk factors for suction curettage (SC) and hysteroscopy in the treatment of type I and II cesarean scar pregnancy (CSP).MethodsThis was a retrospective study including 100 women diagnosed with type I/II CSP. Patients were treated with either ultrasound‐guided SC (SC group) or hysteroscopy resection (surgery group). The success rates, mean operation time, hospitalization duration, hospitalization cost, risk factors, adverse events, and complications were analyzed.ResultsThe success rate of the SC and surgery groups were 85% and 100%, respectively, and the difference was statistically significant (P = 0.032). There was one case of type I CSP and eight cases of type II CSP that failed SC treatment. No failed cases were found in the surgery group. Analysis of the causes of treatment failure revealed that diameter of the gestational sac was a risk factor for SC failure (odds ratio, 19.66 [95% confidence interval {CI}, 1.70–227.72], P = 0.017). Comparing the clinical outcomes between the SC and surgery groups, although the mean operation time of the SC group was significantly shorter than the surgery group (15 [CI, 15–20] vs. 30 [CI, 27–40], P = 0.001), the cost and duration of hospitalization were significantly lower in the surgery group than that in the SC group. No significant differences were observed for adverse events and complications between the two groups (P > 0.05).ConclusionHysteroscopy is an effective and economical method for treating type I/II CSP. Moreover, SC is not recommended for patients with type I/II CSP with a gestation age ≥8 weeks.

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“…Several recent studies have evaluated the efficacy of high intensity focused ultrasound (HIFU) ablation for the treatment of CSEP [34,35 ▪ ,36,37]. HIFU uses 350–400 W of acoustic power to induce coagulative necrosis in the targeted tissue.…”

Section: Surgical Managementmentioning

confidence: 99%

An update and review of nontubal ectopic pregnancy management

Kostroun

Robinson

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review Nontubal ectopic pregnancies appear to be increasing in prevalence. Increasingly, minimally invasive methods for management are being utilized. A current literature review and recommendations for management of nontubal ectopic pregnancy is presented in this review. Recent findings Nontubal ectopic pregnancies are less common than tubal ectopic pregnancies but present a unique and significant threat to patient's health and are optimally managed by specialists familiar with the condition. Early diagnosis, prompt treatment and close follow-up to resolution are critical. Recent publications focus on fertility-sparing and conservative management through the use of medications both systemic and local; as well as minimally invasive surgical techniques. The Society of Maternal Fetal Medicine recommends against expectant management of cesarean scar pregnancies; however, optimal treatment is unknown and this holds true for management of other nontubal ectopic pregnancies. Summary Minimally invasive and fertility sparing management should be the mainstay in treatment of stable patients with nontubal ectopic pregnancy.

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Analysis of the type of cesarean scar pregnancy impacted on the effectiveness and safety of high intensity focused ultrasound combined with ultrasound-guided suction curettage treatment

Cited by 11 publications

References 30 publications

Curative effect of high‐intensity focused ultrasound in management of different types of ectopic pregnancy: A systematic review

Curative effect of high‐intensity focused ultrasound in management of different types of ectopic pregnancy: A systematic review

Clinical efficacy and risk factors for suction curettage and hysteroscopy in patients with type I and II cesarean scar pregnancy

An update and review of nontubal ectopic pregnancy management

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