Uterine artery embolization with and without local methotrexate infusion for the treatment of cesarean scar pregnancy

Qi, Feng; Zhou, Wei; Wang, Mei-Fen; Chai, Zeying; Zheng, Lingzhi

doi:10.1016/j.tjog.2015.01.003

Cited by 24 publications

(16 citation statements)

References 33 publications

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“…A total of 358 articles were identified; 122 were assessed with respect to their eligibility for inclusion and 44 studies were included in the systematic review (Table 1, Figure 1). 9,10,21‐61 These studies included 3598 women with a prior CSP; of these, information on subsequent pregnancy was available for 592 women.…”

Section: Resultsmentioning

confidence: 99%

Reproductive outcome after cesarean scar pregnancy: A systematic review and meta‐analysis

Morlando

Buca

Timor‐Tritsch

et al. 2020

Acta Obstet Gynecol Scand

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Introduction To evaluate subsequent reproductive among women with a prior cesarean scar pregnancy (CSP). Material and methods MEDLINE, Embase and ClinicalTrials.gov databases were searched. Inclusion criteria were women with a prior CSP, defined as the gestational sac or trophoblast within the dehiscence/niche of the previous cesarean section scar or implanted on top of it. The primary outcome was the recurrence of CSP; secondary outcomes were the chance of achieving a pregnancy after CSP, miscarriage, preterm birth, uterine rupture and the occurrence of placenta accreta spectrum disorders. Subgroup analysis according to the management of CSP (surgical vs non‐surgical) was also performed. Random effect meta‐analyses of proportions were used to analyze the data. Results Forty‐four studies (3598 women with CSP) were included. CSP recurred in 17.6% of women. Miscarriage, preterm birth and placenta accreta spectrum disorders complicated 19.1% (65/341), 10.3% (25/243) and 4.0% of pregnancies, and 67.0% were uncomplicated. When stratifying the analysis according to the type of management, CSP recurred in 21% of women undergoing surgical and in 15.2% of those undergoing non‐surgical management. Placenta accreta spectrum disorders complicated 4.0% and 12.0% of cases, respectively. Conclusions Women with a prior CSP are at high risk of recurrence, miscarriage, preterm birth and placenta accreta spectrum. There is still insufficient evidence to elucidate whether the type of management adopted (surgical vs non‐surgical) can impact reproductive outcome after CSP. Further large, prospective studies sharing an objective protocol of prenatal management and long‐term follow up are needed to establish the optimal management of CSP and to elucidate whether it may affect its risk of recurrence and pregnancy outcome in subsequent gestations.

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Section: Resultsmentioning

confidence: 99%

Reproductive outcome after cesarean scar pregnancy: A systematic review and meta‐analysis

Morlando

Buca

Timor‐Tritsch

et al. 2020

Acta Obstet Gynecol Scand

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“…Curettage after UAE is currently accepted as an effective treatment for CSP. UAE can accurately detect and embolize the uterine arteries for efficient reduction of bleeding risk during curettage [2, 17, 18]. However, UAE requires digital imaging equipment and such equipment are expensive.…”

Section: Discussionmentioning

confidence: 99%

“…Cesarean scar pregnancy (CSP) is a potentially life-threatening complication of the cesarean section when the subsequent gestational sac implants on the cesarean scar area or niche [1, 2]. In the absence of early diagnosis and effective treatment, CSP may lead to excessive haemorrhage, emergency hysterectomy, and even maternal mortality [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Efficacy of Ultrasound-Guided Local Lauromacrogol Injection Combined with Aspiration for Cesarean Scar Pregnancy: A Novel Treatment

Chai

Liu

et al. 2017

Gynecol Obstet Invest

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Objectives: To evaluate the efficacy of ultrasound-guided local lauromacrogol injection combined with aspiration for treating cesarean scar pregnancy (CSP). Methods: From July 2016 to December 2016, 18 patients diagnosed with CSP were treated with ultrasound-guided local lauromacrogol injection combined with aspiration. Clinical data and outcome were analysed. Results: All patients were treated successfully. The amount of bleeding ranged between 10 and 50 mL. The duration of hospitalization ranged between 2 and 11 days. Serum β-human chorionic gonadotropin (β-hCG) decreased to the nondetectable level within 19–41 days. Menstruation recovery occurred after 10–24 days of normalization of serum β-hCG level. Reproductive functions were preserved, and there were no untoward effects or complications. Conclusions: Ultrasound-guided local lauromacrogol injection combined with aspiration is an effective CSP therapy, as it was associated with a high success rate, short hospitalization and fast recovery. However, its wider application and popularization have to be validated on a larger patient population affected by CSP.

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“…Поэтому такую беременность следует прерывать в I триместре в условиях стационара, в котором выполняются высокотехнологичные виды медицинской помощи. Современные органосберегающие технологии при БРМ включают широкий арсенал лечебных мероприятий: эмболизацию маточных артерий, перевязку или временное клипирование внутренних подвздошных артерий, введение метотрексата, проведение гистерорезектоскопии под лапароскопическим контролем, выполнение метропластики [18][19][20][21][22].…”

Section: заключениеunclassified

Pregnancy in the scar after caesarean section (case report)

Tskhay¹,

Yametov²,

Nefed’eva³

et al. 2017

Probl. reprod.

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Uterine artery embolization with and without local methotrexate infusion for the treatment of cesarean scar pregnancy

Cited by 24 publications

References 33 publications

Reproductive outcome after cesarean scar pregnancy: A systematic review and meta‐analysis

Reproductive outcome after cesarean scar pregnancy: A systematic review and meta‐analysis

Evaluation of the Efficacy of Ultrasound-Guided Local Lauromacrogol Injection Combined with Aspiration for Cesarean Scar Pregnancy: A Novel Treatment

Pregnancy in the scar after caesarean section (case report)

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