Document Detail


Diagnosis and treatment of cesarean scar pregnancy.
MedLine Citation:
PMID:  18437903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the early diagnosis and treatment of cesarean scar pregnancy (CSP). METHODS: Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. RESULTS: CSP constituted 1.05% of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1:1221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging (MRI). The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. CONCLUSIONS: CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.
Authors:
Lan-zhou Jiao; Jun Zhao; Xi-run Wan; Xin-yan Liu; Feng-zhi Feng; Tong Ren; Yang Xiang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese medical sciences journal = Chung-kuo i hsüeh k'o hsüeh tsa chih / Chinese Academy of Medical Sciences     Volume:  23     ISSN:  1001-9294     ISO Abbreviation:  Chin. Med. Sci. J.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2009-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9112559     Medline TA:  Chin Med Sci J     Country:  China    
Other Details:
Languages:  eng     Pagination:  10-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section*
Cicatrix*
Combined Modality Therapy
Female
Gynecologic Surgical Procedures
Humans
Magnetic Resonance Imaging
Methotrexate / administration & dosage,  therapeutic use*
Pregnancy
Pregnancy, Ectopic / diagnosis*,  therapy*,  ultrasonography
Chemical
Reg. No./Substance:
59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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