Suction curettage as first line treatment in cases with cesarean scar pregnancy: feasibility and effectiveness in early pregnancy

Abstract

The early diagnosis of a CSP (7-8 weeks gestation) with a β-hCG level <17.000 mIU/ml and a myometrial thickness >2 mm can be treated with suction curettage with or without placement of a uterine Foley balloon as curative treatment.

Quantitative risk assessment to guide the treatment of cesarean scar pregnancy

“…Compared with sterile gauze tamponade, Foley catheter tamponade is easy to perform and can drain the blood in the uterine cavity. Therefore, Foley catheter compression can be successfully applied in the prevention and management of bleeding complications of CSP, which is also in accordance with a study by Polat et al …”

Clinical characteristics and salvage management of persistent cesarean scar pregnancy

“…All patients with PCSP in our study presented with different degrees of vaginal bleeding, with 14/38 (37%) complaining of heavy vaginal bleeding. A previous study reported that 11 patients with PCSP suffered heavy vaginal bleeding and two underwent hysterectomy to arrest the heavy bleeding . In our study, 21/38 (55%) patients with PCSP suffered heavy bleeding (> 200 ml) before or during PCSP treatment.…”

“…13 In Polat et al's study of three patients with PCSP, one was treated by an emergent wedge excision of the PCSP mass, the second was treated by an emergent hysterectomy and the third patient was treated by a systemic single intramuscular dose of MTX (50 mg/m 2). 19 In our study, 32/38 (84%) patients were managed by surgical treatment: 24 by repeat surgical evacuation and eight by PCSP mass resection. Surgical evacuation is the most effective method for treating PCSP.…”

Exogenous cesarean scar pregnancies managed by suction curettage alone or in combination with other therapeutic procedures: A series of 33 cases and analysis of complication profile

“…Hence, we may suggest that our adopted clinical criteria in selecting the therapeutic strategy in women diagnosed as exogenous CSP may be reasonable and reliable, as patients who necessitated an additional therapeutic tool presented similar rates of blood transfusion requirement, time required to resolution of β‐hCG and hospital stay as compared to those who were successfully managed with suction curettage only. In the literature, suction curettage, either alone or in combination with other therapeutic modalities, has been described as a safe, efficacious and minimally invasive approach in the management of CSP. Sevket et al .…”

“…There have been a limited number of published studies reporting the use of suction curettage only as the first‐line therapeutic option . The general approach appears to be supplementing suction curettage therapy with an additional therapeutic tool, such as uterine artery embolization (which necessitates experience and expertise and is reported to influence the patient's future reproductive potential), high‐intensity ultrasound (which is an expensive method and not in widespread use) or intramuscular methotrexate (MTX) injection (which has systemic and reproductive side‐effects).…”