Pituitrin local injection versus uterine artery embolization in the management of cesarean scar pregnancy: A retrospective cohort study

2021 ◽  
Author(s):  
Jianing Wang ◽  
Ruiheng Zhao ◽  
Huiying Qian ◽  
Hongdao Lv
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Uterine Artery Embolization ◽  
Retrospective Cohort ◽  
Uterine Artery ◽  
Local Injection ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar

Retrospective cohort study of prophylactic intraoperative uterine artery embolization for abnormally invasive placenta

2017 ◽  
Vol 137 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Yi Pan ◽  
Xin Zhou ◽  
Zhengqiang Yang ◽  
Shudong Cui ◽  
Wei De ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Uterine Artery Embolization ◽  
Retrospective Cohort ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

scholarly journals When to Perform Curettage After Uterine Artery Embolization for Cesarean Scar Pregnancy: a Clinical Study

2021 ◽  
Author(s):  
Qiao Wang ◽  
Hongling Peng ◽  
Xia Zhao ◽  
Xiaorong Qi
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Optimal Time ◽  
Time Interval ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Treatment Interval

Abstract Background: Prophylactic uterine artery embolization (UAE) combined with following curettage was suggested as an effective and minimally invasive treatment strategy for cesarean scar pregnancy (CSP) with high bleeding risk. However, the timing of curettage after UAE remains to be studied. Thus, we aimed to identify the optimal time interval to perform curettage after UAE in patients with CSP.Methods: We conducted a retrospective cohort study in a large medical center for women and children in southwest China. CSP patients treated by UAE combined with following curettage were included and grouped by the treatment time interval between these two procedures. The clinical outcomes among arms were compared by univariate and multi-variable analysis.Results: Our study finally included a total of 314 CSP patients who received this combination treatment in our department from January 2014 to December 2019. The median time interval between UAE and curettage was 48 hours with a range of 12-168 hours in all participants. Thirty-two cases (10.2%) experienced intra-operative hemorrhage (blood loss ≥200mL). Seventeen cases (5.4%) used intrauterine balloon tamponade. Fourteen cases (4.5%) were converted into laparoscopy (or laparotomy). In the cohort study, patients with longer treatment interval had more intra-operative blood loss and higher incidence of complications than those with shorter interval (P＜0.05). The rate of intra-operative bleeding was 5.0% in patients who received curettage within 24 hours after UAE (Arm 1), in comparison with 19.4% in those who had treatment interval longer than 72 hours (Arm 4). In the multi-variable logistic regression model of bleeding, the treatment interval ＞72 hours had an adjusted odds ratio of 3.37 (95% confidence interval: 1.40-8.09). Conclusion: We suggest that curettage should not be delayed longer than 72 hours after UAE under general conditions.

scholarly journals When to perform curettage after uterine artery embolization for cesarean scar pregnancy: a clinical study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiao Wang ◽  
Hongling Peng ◽  
Xia Zhao ◽  
Xiaorong Qi
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Combined Treatment ◽  
Time Interval ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Treatment Interval

Abstract Background Prophylactic uterine artery embolization (UAE) combined with subsequent curettage is suggested as an effective and minimally invasive treatment strategy for cesarean scar pregnancy (CSP) with a high bleeding risk. However, the timing of curettage after UAE remains to be studied. Thus, we aimed to identify the optimal time interval to perform curettage after UAE in patients with CSP. Methods We conducted a retrospective cohort study in a large medical center for women and children in Southwest China. CSP patients treated by UAE combined with subsequent curettage were included and grouped by the treatment time interval between these two procedures. The clinical outcomes among arms were compared by univariate and multivariable analysis. Results Our study included 314 CSP patients who received this combination treatment in our department from January 2014 to December 2019. The median time interval between UAE and curettage was 48 h, with a range of 12-168 h among all participants. Thirty-two patients (10.2%) experienced intraoperative hemorrhage (blood loss ≥200 mL). Intrauterine balloon tamponade was used in 17 cases (5.4%). In 14 cases (4.5%), the procedure was converted to laparoscopy (or laparotomy). In the cohort study, patients with longer treatment intervals had more intraoperative blood loss and a higher incidence of complications than those with shorter intervals (P < 0.05). The rates of intraoperative bleeding were 5.0% for patients who received curettage within 24 h after UAE (Arm 1) and 19.4% for those who had a treatment interval longer than 72 h (Arm 4). In the multivariable logistic regression model of bleeding, a treatment interval > 72 h had an adjusted odds ratio of 3.37 (95% confidence interval: 1.40-8.09). Conclusion We suggest that curettage not be delayed longer than 72 h after UAE in this combined treatment of CSP.

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.

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

2015 ◽  
Vol 294 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Wei Liu ◽  
Liang Shen ◽  
Qingwen Wang ◽  
Wei Wang ◽  
Zengtao Sun
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar

scholarly journals Incorporating uterine artery embolization in the treatment of cesarean scar pregnancy following diagnostic ultrasonography

2016 ◽  
Vol 134 (2) ◽  
pp. 202-207 ◽  
Author(s):  
Yang Li ◽  
Weiwen Wang ◽  
Ting Yang ◽  
Xing Wei ◽  
Xiaofeng Yang
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Diagnostic Ultrasonography
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