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Uterine Artery Embolization Combined with Dilation and Curettage for the Treatment of Cesarean Scar Pregnancy: Efficacy and Future Fertility

CardioVascular and Interventional Radiology volume 41, pages 1165–1173 (2018)Cite this article

Abstract

Purpose

To investigate the efficacy and safety of uterine artery embolization (UAE) followed by dilation and curettage (D&C) as a treatment for cesarean scar pregnancy (CSP) and to assess pregnancy outcomes after the treatment.

Materials and Methods

We retrospectively analyzed 33 CSP patients treated with UAE followed by D&C. The serum level of beta human chorionic gonadotropin (β-hCG) normalization, hospitalization, menstruation, and successful pregnancy after treatment was assessed as clinical and pregnancy outcomes.

Results

A total of 33 patients were initially treated without severe complications. However, four patients required additional systemic chemotherapy. β-hCG normalization took 35.5 ± 14.9 days (range 13–79), and the hospitalization was 6.5 ± 2.5 days (2–15). All patients resumed normal menstruation after 36 ± 19.2 days (12–86). Of 16 of 33 patients who desired pregnancy after the treatment, seven patients (43.8%) had uneventful parturition.

Conclusions

UAE combined with D&C was efficient and safe for CSP management. This minimally invasive procedure may be considered as one of the treatment options which enable preservation of fertility after treatment.

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Author information

Affiliations

  1. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan

    Amartuvshin Tumenjargal, Hiroyuki Tokue, Hiromi Hirasawa, Ayako Taketomi-Takahashi & Yoshito Tsushima

  2. Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 371-8511, Japan

    Hiroshi Kishi

  3. Department of Obstetrics and Gynecology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia

    Amartuvshin Tumenjargal

Authors
  1. Amartuvshin Tumenjargal
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  2. Hiroyuki Tokue
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  3. Hiroshi Kishi
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  4. Hiromi Hirasawa
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  5. Ayako Taketomi-Takahashi
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  6. Yoshito Tsushima
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Contributions

All authors participated in the study design. AT collected the data, carried out the analysis, and drafted the manuscript. HT supervised the overall study process. HT and YT revised the manuscript. AT-T checked English correction of the manuscript. All authors contributed to the writing of the final manuscript and approved it to be published.

Corresponding author

Correspondence to Hiroyuki Tokue.

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Conflict of interest

The authors declare that they have no conflicts of interest and nothing to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Synopsis Uterine Artery Embolization combined with Dilation and Curettage is preferred as a safe and efficient treatment in 33 cases with cesarean scar pregnancy.

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Tumenjargal, A., Tokue, H., Kishi, H. et al. Uterine Artery Embolization Combined with Dilation and Curettage for the Treatment of Cesarean Scar Pregnancy: Efficacy and Future Fertility. Cardiovasc Intervent Radiol 41, 1165–1173 (2018). https://doi.org/10.1007/s00270-018-1934-z

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  • DOI: https://doi.org/10.1007/s00270-018-1934-z

Keywords

  • Cesarean scar pregnancy
  • Dilation and curettage
  • Fertility
  • Pregnancy outcomes
  • Uterine artery embolization