Local intra-gestational sac methotrexate injection followed by dilation and curettage in treating cesarean scar pregnancy

2020 ◽  
Vol 302 (2) ◽  
pp. 439-445 ◽  
Author(s):  
Kai-Liang Tan ◽  
Li Jiang ◽  
Yu-Mei Chen ◽  
Ying Meng ◽  
Bang-Quan Lv ◽  
...  
Keyword(s):  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Dilation And Curettage ◽  
Gestational Sac

scholarly journals Risk factors for poor hemostasis of prophylactic uterine artery embolization before curettage in cesarean scar pregnancy

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096437
Author(s):  
Hongan Tian ◽  
Shunzhen Li ◽  
Wanwan Jia ◽  
Kaihu Yu ◽  
Guangyao Wu
Keyword(s):  
Risk Factors ◽  
Blood Supply ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Embolic Agent ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Hemorrhage Volume ◽  
Gestational Sac

Objective To observe the hemostatic effect of prophylactic uterine artery embolization (UAE) in patients with cesarean scar pregnancy (CSP) and to examine the risk factors for poor hemostasis. Methods Clinical data of 841 patients with CSP who underwent prophylactic UAE and curettage were retrospectively analyzed to evaluate the hemorrhage volume during curettage. A hemorrhage volume ≥200 mL was termed as poor hemostasis. The risk factors of poor hemostasis were analyzed and complications within 60 days postoperation were recorded. Results Among the 841 patients, 6.30% (53/841) had poor postoperative hemostasis. The independent risk factors of poor hemostasis were gestational sac size, parity, embolic agent diameter (>1000 μm), multivessel blood supply, and incomplete embolization. The main postoperative complications within 60 days after UAE were abdominal pain, low fever, nausea and vomiting, and buttock pain, with incidence rates of 71.22% (599/841), 47.44% (399/841), 39.12% (329/841), and 36.39% (306/841), respectively. Conclusions Prophylactic UAE before curettage in patients with CSP is safe and effective in reducing intraoperative hemorrhage. Gestational sac size, parity, embolic agent diameter, multivessel blood supply, and incomplete embolization of all arteries supplying blood to the uterus are risk factors of poor hemostasis.

scholarly journals Cesarean Scar Pregnancy Treated by Artery Embolization Combined with Diode Laser: A Novel Approach for a Rare Disease

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 411
Author(s):  
Felice Sorrentino ◽  
Vincenzo De Feo ◽  
Guglielmo Stabile ◽  
Raffaele Tinelli ◽  
Maurizio Nicola D’Alterio ◽  
...  
Keyword(s):  
Diode Laser ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Artery Ligation ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Dilation And Curettage ◽  
Management Protocol ◽  
Future Fertility

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy which represents a consequence of a previous cesarean section. It is associated with major maternal morbidity and mortality and has potential implications on future fertility. Because of possible serious complications, CSP should be swiftly diagnosed and treated. There is no management protocol for this rare, life-threatening condition, and each patient should be evaluated individually. Several types of conservative treatment have been used to treat cesarean scar pregnancy: dilation and curettage (D&C), excision of trophoblastic tissues, local or systemic administration of methotrexate, bilateral hypogastric artery ligation, and selective uterine artery embolization with curettage and/or methotrexate administration. In our study we present a cesarean scar pregnancy of a 40-year-old woman who was treated with angiographic uterine artery embolization (UAE) followed by hysteroscopic diode laser resection. Our combined UAE–hysteroscopic laser surgery appears to offer an effective, safe, and minimally invasive surgical treatment.

Management of Cesarean Scar Pregnancy Using Ultrasound-Guided Dilation and Curettage

2016 ◽  
Vol 23 (5) ◽  
pp. 707-711 ◽  
Author(s):  
Suqing Liu ◽  
Jing Sun ◽  
Bin Cai ◽  
Xiaowei Xi ◽  
Liu Yang ◽  
...  
Keyword(s):  
Ultrasound Guided ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Dilation And Curettage

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

2018 ◽  
Vol 41 (8) ◽  
pp. 1165-1173 ◽  
Author(s):  
Amartuvshin Tumenjargal ◽  
Hiroyuki Tokue ◽  
Hiroshi Kishi ◽  
Hiromi Hirasawa ◽  
Ayako Taketomi-Takahashi ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Dilation And Curettage ◽  
Future Fertility

scholarly journals Resection of Cesarean Scar Pregnancy at Six Weeks of Gestation with Laminaria Cervical Dilatation under Sonographic and Hysteroscopic Guidance

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Tatsuji Hoshino ◽  
Taito Miyamoto ◽  
Shinya Yoshioka
Keyword(s):  
Transvaginal Ultrasound ◽  
Clinical History ◽  
Anterior Wall ◽  
Cervical Dilatation ◽  
Cesarean Scar Pregnancy ◽  
Chorionic Villi ◽  
Cesarean Scar ◽  
Decidua Basalis ◽  
Gestational Sac ◽  
Almost All

In cases of fetal heartbeat- (FHB-) positive cesarean scar pregnancy (CSP), the embryo and placenta grow rapidly week by week. We experienced an FHB-positive CSP case at 6 weeks of gestation and assessed the CSP in detail with transvaginal ultrasound and transabdominal ultrasound (TAUS), preoperatively. We performed Laminaria cervical dilatation under TAUS guidance and performed hysteroscopic resection of the pregnancy conceptus and curettage under hysteroscopic and TAUS guidance. We identified the gestational sac attached to the cesarean scar pouch with small plane, decidua basalis, and chorionic villi and present the clinical history and other findings. We also reviewed the related literature and found 76 previous studies, with six cases of FHB-positive CSP that contained hysteroscopic color images of the CSP. We present a review of selected cases. The implantation site was the anterior wall in almost all cases. Cervical dilatation was mainly performed using a Hegar dilator; ours was the only case using Laminaria dilatation. Transcervical resections were performed mainly under ultrasound guidance, with only one case undergoing laparoscopy. Electrocoagulation was performed in three of the six cases.

scholarly journals A Case of Misdiagnosed Cesarean Scar Pregnancy with a Viable Birth at 28 Weeks

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Sakiko Nukaga ◽  
Shigeru Aoki ◽  
Kentaro Kurasawa ◽  
Tsuneo Takahashi ◽  
Fumiki Hirahara
Keyword(s):  
Early Pregnancy ◽  
Ultrasound Image ◽  
Uterine Cavity ◽  
Normal Pregnancy ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Gestational Sac ◽  
Previous Cesarean ◽  
Made In

We report our experience with a case of presumptive cesarean scar pregnancy, based on detection of a gestational sac (GS) in early pregnancy at the site of a previous cesarean scar. The GS grew into the uterine cavity as the pregnancy progressed, showing an ultrasound image similar to that of a normal pregnancy. Thus, the pregnancy continued, resulting in a viable birth at 28 weeks of gestation. Cesarean scar pregnancy is classified as myometrial implantation or implantation growth into the uterine cavity. In the latter type, the gestational sac moves upward with increasing gestational weeks and it shows the same ultrasound image as a normal pregnancy. Therefore, the diagnosis must be made in the early pregnancy.

Sign in / Sign up

Export Citation Format

Share Document