Document Detail


Uterine artery embolisation combined with local methotrexate for treatment of caesarean scar pregnancy.
MedLine Citation:
PMID:  20536432     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of the study was to determine the efficacy of uterine artery embolisation (UAE) combined with local methotrexate (MTX) for the treatment of caesarean scar pregnancy, compared with other traditional modalities, and to investigate the complications associated with this treatment. DESIGN: A retrospective cohort study. SETTING: A large obstetrics and gynaecology unit within a university hospital in China. SAMPLE: Women who were diagnosed with a caesarean scar pregnancy between January 2003 and December 2008, and who had informative case records, were included in the study. METHODS: We reviewed the results for all women who received one of three treatments: dilation and curettage (D&C) (11 patients; group A), systemic MTX (17 patients; group B), and UAE and local MTX (38 patients; group C). MAIN OUTCOME MEASURES: The main outcome measures were success rate, blood loss, time for beta human chorionic gonadotrophin (beta-hCG) to decline to normal values, and the duration of hospital stay. Success was defined as a complete recovery with no severe complications and with the preservation of fertility. RESULTS: A total of 66 women diagnosed with caesarean scar pregnancy between January 2003 and December 2008 were identified, and their data were analysed. The success rate in group C was significantly higher than that in groups A and B after adjusting for beta-hCG level (89.5 versus 27.3 and 58.8%, respectively; P < 0.001). The mean blood loss in group C was lower than in the other two groups (240.5 versus 855.5 and 639.4 ml, respectively; P = 0.008 and 0.009, respectively). The average time for beta-hCG to decline to normal values was significantly shorter in group C than in group B (28.1 versus 44.3 days; P = 0.021). A significantly shorter duration of hospital stay was observed in group C compared with group B (12.5 versus 22.0 days; P = 0.024). CONCLUSIONS: UAE combined with local MTX is of benefit to women wishing to preserve fertility, and is suitable for use as the primary treatment for caesarean scar pregnancy.
Authors:
X-Y Yang; H Yu; K-M Li; Y-X Chu; A Zheng
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  990-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage*
Administration, Topical
Adult
Cesarean Section / adverse effects*
Chorionic Gonadotropin, beta Subunit, Human / metabolism
Cicatrix / therapy*
Combined Modality Therapy / methods
Female
Humans
Methotrexate / administration & dosage*
Middle Aged
Pregnancy
Pregnancy Complications / therapy*
Pregnancy Complications, Cardiovascular / therapy
Pregnancy, Ectopic / therapy
Retrospective Studies
Uterine Artery Embolization / methods*
Young Adult
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Chorionic Gonadotropin, beta Subunit, Human; 59-05-2/Methotrexate

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