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Curettage or operative hysteroscopy in the treatment of cesarean scar pregnancy

Archives of Gynecology and Obstetrics volume 292, pages 1055–1061 (2015)Cite this article

Abstract

Objectives

To compare the clinical effects of dilatation and curettage (D&C) regimen and operative hysteroscopy coupled with curettage regimen in the treatment of cesarean scar pregnancy (CSP) following preventive uterine artery embolization (UAE).

Materials and methods

Thirty-three women were treated with D&C after UAE (group A) and 33 women were treated with operative hysteroscopy coupled with curettage after UAE (group B). The clinical outcomes of the two groups were compared.

Results

There was no significant difference between the two groups with respect to the success rate, the intraoperative blood loss, the hysterectomy rate, the hospitalization time, the decline of serum β-hCG after surgery, the time of serum β-hCG resolution, the time of vaginal bleeding after surgery, the time to CSP mass disappearance, and the subsequent intrauterine pregnancies. The hospitalization cost in group B was higher than group A.

Conclusions

Both D&C and operative hysteroscopy coupled with curettage were successful in terminating a CSP. Hysteroscopy coupled with curettage regimen did not have significant advantages and good prognosis in dealing with the gestational sac type of CSP following preventive UAE compared with D&C regimen. Treatment should be individualized and several conditions must be considered.

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Acknowledgments

This work was supported by the Program for Zhejiang Leading Team of S & T Innovation, P. R. China (No.: 2011R50013-25), Program for Key Subjects of Zhejiang Province in Medicine & Hygiene, P. R. China (No.: 11-ZC18), Program for Key Subjects Group of Reproductive Medicine at Zhejiang Province, P. R. China (No.: XKQ-009-002), Program for Changjiang Scholars and Innovative Research Team in University, P. R. China (No.: IRT1184), and the National Basic Research Program of China (2012CB944902).

Conflict of interest

We declare that we have no conflict of interest. We do not have financial relationships with any organizations. We have had full control of all primary data and we agree to allow the Journal to review our data if requested.

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Affiliations

  1. Department of Obstetrics and Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, People’s Republic of China

    Zhi-Da Qian, Li-Li Huang & Xiao-Ming Zhu

  2. Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou, People’s Republic of China

    Xiao-Ming Zhu

Authors
  1. Zhi-Da Qian
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  2. Li-Li Huang
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  3. Xiao-Ming Zhu
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Correspondence to Xiao-Ming Zhu.

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Qian, ZD., Huang, LL. & Zhu, XM. Curettage or operative hysteroscopy in the treatment of cesarean scar pregnancy. Arch Gynecol Obstet 292, 1055–1061 (2015). https://doi.org/10.1007/s00404-015-3730-1

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  • DOI: https://doi.org/10.1007/s00404-015-3730-1

Keywords

  • Cesarean scar pregnancy
  • Dilatation and curettage
  • Hysteroscopy
  • Uterine artery embolization
  • Treatment