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Uterine artery embolization combined with curettage vs. methotrexate plus curettage for cesarean scar pregnancy

Archives of Gynecology and Obstetrics volume 294, pages 71–76 (2016)Cite this article

Abstract

Purpose

To compare the efficacy and safety of uterine artery embolization (UAE) combined with curettage and methotrexate (MTX) plus curettage in the treatment of cesarean scar pregnancy (CSP).

Methods

From January 2005 to December 2013, we treated 38 CSP patients with UAE combined with curettage, and another 26 patients with CSP were treated with methotrexate (MTX) plus curettage. The resulting data were analyzed statistically.

Results

The median volume of blood loss was 17.5 ml in the UAE combined with curettage (UAE-C) group vs. 335 ml in the MTX plus curettage (MTX-C) group (p < 0.001). The time from the procedure till β-human chorionic gonadotropin (β-hCG) concentration returned to normal was 25.13 ± 3.74 days in the UAE-C group vs. 56.15 ± 15.99 days in the MTX-C group (p < 0.001). The duration of hospitalization was 7.44 ± 1.92 vs. 19.38 ± 8.75 days, respectively (p < 0.001). The percentage of side effects in the UAE-C group was significantly lower than in the MTX-C group.

Conclusions

UAE combined with curettage appears to be superior to MTX plus curettage for treatment of CSP with high serum β-hCG level, though prospective trials are needed.

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Acknowledgments

This study was supported by a grant from the Science and Technology Research Projects of the Population and Family Planning Commission of Shandong, China (no. 9 2012;) and by funds from the Shandong Science and Technology Development Plans (2013GSF11907 and 2014GGH218027).

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Affiliations

  1. Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250012, Shandong, People’s Republic of China

    Wei Liu & Liang Shen

  2. Department of Interventional Radiology, Shandong Medical Imaging Research Institute, 324 Jingwu Road, Jinan, 250012, Shandong, People’s Republic of China

    Qingwen Wang & Zengtao Sun

  3. Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People’s Republic of China

    Wei Wang

Authors
  1. Wei Liu
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  2. Liang Shen
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  3. Qingwen Wang
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  4. Wei Wang
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  5. Zengtao Sun
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Corresponding author

Correspondence to Wei Liu.

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Liu, W., Shen, L., Wang, Q. et al. Uterine artery embolization combined with curettage vs. methotrexate plus curettage for cesarean scar pregnancy. Arch Gynecol Obstet 294, 71–76 (2016). https://doi.org/10.1007/s00404-015-3952-2

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  • DOI: https://doi.org/10.1007/s00404-015-3952-2

Keywords

  • Cesarean scar pregnancy
  • Treatment
  • Uterine artery embolization
  • Curettage
  • Methotrexate