VP59.10: Assessment of early pregnancy implantation site: reproducibility of 3D ultrasound measurements

Abstract

Virtual poster abstracts at the rate of 0.15% were diagnosed by trans-vaginal scan. Group A comprised 15 patients with embryonic/fetal cardiac activity and Group B comprised 6 patients without embryonic cardiac activity. Group A: 46% had intra-gestational injection of KCL and methotrexate with full resolution. 20% had Uterine Artery Embolisation followed by surgical evacuation. 10.3 % had systemic methotrexate 2 doses which later needed intra-gestational KCL and methotrexate. Only 3% had resolution with 2 doses of systemic methotrexate. 6.6 % had intra-gestational KCL/methotrexate with Foleys catheter tamponade. 6.6% had hysterectomy who presented at 18-20wks with intraperitoneal bleeding. 6.6 % lost follow up. Group B: 63.3 % had intra-gestational methotrexate and had full resolution. 20 % had systemic methotrexate with full resolution in 3-4 months duration. 16.6 % lost follow up. Conclusions: The incidence of CSP is increasing and previous Caesarean section is an important risk factor. There is a need to keep the primary Caesarean section rates at a low level. There is no consensus regarding the best treatment for CSP. Trans-vaginal ultrasound seems to be the best diagnostic tool to establish the diagnosis before 8wks. Medical management using intra-gestational injection of KCL with methotrexate appears to be an acceptable treatment in clinically stable women. The use of single treatment modalities like surgical evacuation or systemic methotrexate alone is not recommended.