Randomized controlled trial of hysteroscopy or ultrasonography versus no guidance during D&amp;C after uterine artery chemoembolization for cesarean scar pregnancy

Li, Yanli; Gong, Li-yan; Wu, Xingjiang; Gao, Han; Zheng, Hongxing; Lan, Weishun

doi:10.1016/j.ijgo.2016.04.019

Cited by 25 publications

(34 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several factors are associated with the formation of a PCSP mass. Firstly, a prior study confirmed that a previous cesarean scar defect is a common presentation among women with CSP and trophoblastic tissue is located within the defect, making it inaccessible for surgical evacuation . Thus, the proportion of women who underwent surgical evacuation of CSP diagnosed with retained product of contraception on postprocedure ultrasound examination was higher when compared to women who underwent surgical evacuation of failed intrauterine pregnancies .…”

Section: Discussionmentioning

confidence: 95%

“…Zhang et al reported that eight patients with PCSP were treated successfully by laparoscopic scar pregnancy resection and scar‐defect repair, while two patients were treated by hysteroscopy . In Li et al .’s study, six patients with PCSP were treated by repeat surgical evacuation with hysteroscopy guidance . In their study, Wu et al .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have confirmed the clinical efficacy and safety of transvaginal surgical evacuation . However, persistent remains of an ectopic pregnancy mass after surgical evacuation (described as residual gestational tissue), retained products of conception or pregnancy remnants have also been reported . The term “persistent cesarean scar pregnancy” originated with a 2012 case series by Zhang et al and was used to diagnose CSP with the persistent remains of an ectopic pregnancy mass after surgical evacuation .…”

Section: Introductionmentioning

confidence: 99%

“…First‐line treatment for CSP has not yet been established. Although many methods have been reported, transvaginal surgical evacuation under ultrasound or hysteroscopy guidance has been widely adopted in China . Previous studies have confirmed the clinical efficacy and safety of transvaginal surgical evacuation .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical characteristics and salvage management of persistent cesarean scar pregnancy

Ying

Zheng

Zhao

et al. 2017

J of Obstet and Gynaecol

View full text Add to dashboard Cite

AimThe study was conducted to illustrate the clinical characteristics and treatment outcomes of patients with persistent cesarean scar pregnancy (PCSP).MethodsDuring a six‐year period, 38 cases of PCSP were diagnosed and treated conservatively to preserve fertility. The clinical presentations, imaging findings and treatment outcomes of these patients were reviewed.ResultsFourteen out of 38 women (37%) presenting with PCSP suffered heavy vaginal bleeding. Gestational age at diagnosis was 73.1 ± 21.7 days. The maximum diameter of the PCSP mass was 3.6 ± 1.6 cm. The presence of a rich vascular pattern in the area of the PCSP mass was detected by ultrasound in 33/38 (87%) patients. Six patients with a PCSP gestational age of 64.2 ± 6.2 days and a mass diameter of 2.5 ± 0.6 cm were successfully treated with medical treatment alone and 32 patients with a gestational age of 74.8 ± 23.1 days and a mass diameter of 3.8 ± 1.6 cm were successfully treated with surgical or combined treatment.ConclusionsPatients with PCSP are diagnosed at advanced gestational age and are more prone to heavy bleeding. Surgery is the main treatment for PCSP. Medical treatment of PCSP has become an attractive alternative, especially for hemodynamically stable patients with a PCSP mass with a maximum diameter of < 3.5 cm.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical characteristics and salvage management of persistent cesarean scar pregnancy

Ying

Zheng

Zhao

et al. 2017

J of Obstet and Gynaecol

View full text Add to dashboard Cite

show abstract

“…Nowadays, the treatment objective for a CSP is to terminate the pregnancy, reduce bleeding and reserve the patient's fertility. Transvaginal surgical evacuation undersound or hysteroscopy guidance has been widely adopted in China 5,6 . This method not only has minimal invasion and rapid recovery, but also can preserve fertility.…”

Section: Introductionmentioning

confidence: 99%

Association of hemorrhage at termination in caesarean scar pregnancy using the crossover sign of ultrasound image

Yan

Tan

Cheng

et al. 2020

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Purpose To analyze whether crossover sign (COS) can help predict the risk of bleeding during surgical evacuation in patients with caesarean scar pregnancy (CSP). Methods This study retrospectively analyzed the clinical presentations, ultrasound images and treatment outcomes of patients with CSP. The relationship among the gestational sac, caesarean scar and the anterior uterine wall, defined as the COS, was analyzed to predict the risk of severe bleeding during surgical evacuation in these patients. All patients were categorized according to the relationship between the endometrial line and the superior–inferior diameter of the gestational sac into crossover sign‐1 and crossover sign‐2 groups. The Mann–Whitney U test was used to compare the data with non‐normal distribution, and logistic regression analysis was performed to identify the correlates of severe bleeding. Results A total of 74 patients were included. In COS‐1 group (n = 21), 16 (76.19%) patients suffered heavy bleeding(≥200 mL) during surgical evacuation, while COS‐2 group (n = 53) had only 1(11.89%) patient complaint of heavy bleeding (≥200 mL) (P < 0.01). Adverse surgical outcomes were more common in women with COS‐1. Logistic regression analysis showed that COS‐1 (OR, 7.93; 95% CI, 1.35–46.67) was independently associated with severe bleeding. Conclusion COS can help predict who has a higher risk of severe hemorrhage in patients with CSP and guide the clinical treatment selection for optimal management of this condition.

show abstract

Interventions for non-tubal ectopic pregnancy

Long

Zhu

et al. 2020

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Randomized controlled trial of hysteroscopy or ultrasonography versus no guidance during D&C after uterine artery chemoembolization for cesarean scar pregnancy

Abstract: Hysteroscopy or ultrasonography monitoring of D&C after UACE for CSP treatment can decrease the complication rate. ClinicalTrials.gov: NCT02357095.

Cited by 25 publications

References 23 publications

Clinical characteristics and salvage management of persistent cesarean scar pregnancy

Clinical characteristics and salvage management of persistent cesarean scar pregnancy

Association of hemorrhage at termination in caesarean scar pregnancy using the crossover sign of ultrasound image

Interventions for non-tubal ectopic pregnancy

Contact Info

Product

Resources

About