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Transvaginal surgical treatment of cesarean scar ectopic pregnancy.
MedLine Citation:
PMID:  23143407     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To explore the feasibility of surgical management of cesarean scar ectopic pregnancy (CSEP) using a transvaginal approach. METHODS: Thirty-eight patients with CSEP presenting at the Shenzhen Nanshan People's hospital between January 2008 and May 2012 were reviewed in the study. Ten patients underwent uterine artery embolization, 13 patients underwent endoscopic CSEP removal in combination with chemotherapy and 15 received transvaginal surgical therapy (transvaginal group). Patients were followed up for between 3 and 48 months. RESULTS: Postoperative fever and irregular menstrual bleeding after healing were each observed in one of ten patients undergoing embolization. No pregnancies were reported in this group during follow-up. Endoscopy procedures included two patients undergoing laparoscopy and 11 undergoing hysteroscopy resection. There were six pregnancies during follow-up in this group. Transvaginal surgery was performed uneventfully in all cases. All patients recovered without complications. There were no reports of irregular menstrual bleeding or changes in menstrual blood volume. Serum HCG levels declined rapidly to within the normal range. The time to menstrual cycle recovery (29.2 ± 5.7 days) was significantly shorter than with endoscopic surgery (37.6 ± 8.2 days) or embolization (64.4 ± 9.2 days; P < 0.05). Three patients became pregnant after transvaginal surgery. CONCLUSION: Transvaginal removal of ectopic pregnancy tissue is a new surgical approach for the treatment of CSEP. The efficacy and safety of the approach needs further confirmation.
Authors:
Aiwen Le; Lili Shan; Tianhui Xiao; Ruo Zhuo; Huijian Xiong; Zhonghai Wang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-11
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  -     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynecology, Nanshan Affiliated Hospital of Guangdong Medical College, Shenzhen, 518052, China.
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