scholarly journals Evaluation of the necessity of laparoscopic repair of a uterine scar defect for cesarean scar pregnancy

2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110707
Author(s):  
Jiangdong Xiang ◽  
Yannan Cao ◽  
Lina Zhou ◽  
Haiying Yang ◽  
Sufang Wu ◽  
...  
Keyword(s):  
Gestational Age ◽  
Laparoscopic Repair ◽  
Ultrasound Guided ◽  
Cesarean Scar Pregnancy ◽  
Factors Associated ◽  
Suction Curettage ◽  
Defect Repair ◽  
Gestational Sac ◽  
Uterine Scar ◽  
Myometrial Thickness

Objective This study aimed to determine the risk factors associated with the necessity of laparoscopic scar defect repair for cesarean scar pregnancy (CSP). Methods We retrospectively analyzed 237 patients with CSP who were treated by ultrasound-guided suction curettage and/or laparoscopy in our hospital from April 2012 to November 2019. A total of 199 of these patients underwent ultrasound-guided suction curettage without uterine scar defect repair, while 38 of these patients underwent laparoscopic resection and uterine scar defect repair. We analyzed various clinical variables and compared the efficacy of treatment between the two groups. Results Gestational age, the maximum transverse diameter (MTD) of the gestational sac, myometrial thickness, the operation time, intraoperative blood loss, and the duration of the hospital stay were significantly different between the two groups. Gestational age, the MTD of the gestational sac, and myometrial thickness were independent risk factors for laparoscopic repair. Conclusions Gestational age, the MTD of the gestational sac, and myometrial thickness are important factors associated with the necessity for laparoscopic repair of a uterine scar defect.

scholarly journals Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy

2019 ◽  
Vol 3 (1) ◽  
pp. 01-04
Author(s):  
Hend S Saleh ◽  
Hala E Sherif ◽  
Eman M Mahfouz
Keyword(s):  
Single Dose ◽  
Gestational Age ◽  
Wedge Resection ◽  
Rare Condition ◽  
Prospective Clinical Study ◽  
Maternal Complications ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Suction Curettage ◽  
The Mean

Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

scholarly journals Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy

2019 ◽  
Vol 3 (3) ◽  
pp. 01-05
Author(s):  
Hend Saleh
Keyword(s):  
Single Dose ◽  
Gestational Age ◽  
Wedge Resection ◽  
Rare Condition ◽  
Prospective Clinical Study ◽  
Maternal Complications ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Suction Curettage ◽  
The Mean

Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

Is ultrasound-guided suction curettage a reliable option for treatment of cesarean scar pregnancy? A cross-sectional retrospective study

2017 ◽  
Vol 31 (22) ◽  
pp. 2953-2958 ◽  
Author(s):  
Hüseyin Çağlayan Özcan ◽  
Mete Gurol Uğur ◽  
Özcan Balat ◽  
Seyhun Sucu ◽  
Aynur Mustafa ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ultrasound Guided ◽  
Cesarean Scar Pregnancy ◽  
Cross Sectional ◽  
Cesarean Scar ◽  
Suction Curettage

scholarly journals Clinical analysis of mifepristone combined with transabdominal ultrasound-guided suction and curettage for different types of scar pregnancy

2021 ◽  
Author(s):  
Hongmei Lian ◽  
dejun chen ◽  
Jingxia Zheng ◽  
Ling Zhang
Keyword(s):  
Clinical Analysis ◽  
Type I ◽  
Type Ii ◽  
Transabdominal Ultrasound ◽  
Ultrasound Guided ◽  
Cesarean Scar Pregnancy ◽  
Type Iii ◽  
Suction Curettage ◽  
Β Hcg ◽  
Child Hospital

Abstract Background Cesarean scar pregnancy (CSP) is a life-threatening condition without consensus on treatment. The purpose of this study was to evaluate the safety, efficacy, and outcome of mifepristone combined with transabdominal ultrasound-guided suction and curettage (TUSC) in the treatment of CSP. Methods CSP patients who treated with mifepristone combined TUSC at Maternal and Child Hospital of Hubei Province from 2013 to 2015 was retrospectively analyzed. Patients were divides into three types based on the newest classification criteria in China. Clinical information and outcomes were analyzed. Results 157 CSP patients were included, with 96 type I cases, 56 type II cases and 5 type III cases. No significant differences in age, gravity, parity, gestational age and initial β-human chorionic gonadotropin (β-hCG) levels among the three types. All patients were successfully treated with mifepristone combined with TUSC. No one needed emergency blood transfusion or another treatment. After mifepristone combined with TUSC treatment, the percentage changes of the β-hCG levels were similar in all CSP types. The average of intraoperative blood loss in type I patients during suction curettage was lower than in type II and type III, and more Foley catheters were inserted into the uterus in type II and type III than type I patients to achieve hemostasis. Conclusion Mifepristone combined with TUSC appears to be a safety and efficacy treatment option to all types of CSP.

scholarly journals Approaches in the Treatment of Cesarean Scar Pregnancy and Risk Factors for Intraoperative Hemorrhage: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Yaying Lin ◽  
Chang Xiong ◽  
Chunlin Dong ◽  
Jinjin Yu
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Tissue Blood Flow ◽  
Type I ◽  
Transabdominal Ultrasound ◽  
Intraoperative Blood Loss ◽  
Ultrasound Guided ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Gestational Sac

Background: Cesarean scar pregnancy (CSP) involves a rare form of placental attachment that often leads to life-threatening conditions. The best treatment for CSP has been debated for decades. We aimed to evaluate the different treatments for CSP and analyzed the risk factors for intraoperative hemorrhage.Methods: CSP patients treated at the Affiliated Hospital of Jiangnan University were reviewed retrospectively from January 2014 to 2020. CSP was classified into three types based on the location and shape of gestational tissue, blood flow features, and thickness of the myometrium at the incision site. The clinical characteristics, types, approaches of treatment, and clinical outcomes of CSP were analyzed.Results: A total of 55 patients were included in this study, 29 (52.7%) of whom underwent transvaginal curettage after uterine artery embolization (UAE) and 22 (40%) of whom underwent transabdominal ultrasound-guided hysteroscopic curettage (USHC) in type I and II. Four patients (7.3%) classified as type III underwent laparoscopic cesarean scar resection (LCSR). Intraoperative blood loss, blood transfusion rate, and scar diverticulum were significantly higher in type II than in type I (P < 0.05). Even though USHC showed no differences in intraoperative blood loss, length of stay, and scar diverticulum compared with curettage after UAE (P > 0.05), superiority was found in surgical time and hospitalization cost (P < 0.05). Furthermore, the type of CSP (OR = 10.53, 95% CI: 1.69–65.57; P = 0.012) and diameter of the gestational sac (OR = 25.76, 95% CI: 2.67–248.20; P = 0.005) were found to be risk factors for intraoperative hemorrhage.Conclusions: Transabdominal ultrasound-guided hysteroscopic curettage is an effective and relatively safe treatment option for patients with CSP. Type of CSP and diameter of the gestational sac were found to be associated with excessive intraoperative hemorrhage.

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