scholarly journals Analysis on clinical effects of dilation and curettage guided by ultrasonography versus hysteroscopy after uterine artery embolization in the treatment of cesarean scar pregnancy

2019 ◽  
Vol Volume 15 ◽  
pp. 83-89 ◽  
Author(s):  
Jian Qiu ◽  
Yunfeng Fu ◽  
Jiewei Xu ◽  
Xiaohong Huang ◽  
Guorong Yao ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Clinical Effects ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Dilation And Curettage

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 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 The Analysis of Efficacy and Failure Factors of Uterine Artery Methotrexate Infusion and Embolization in Treatment of Cesarean Scar Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Xiao An ◽  
Xu Ming ◽  
Ke Li ◽  
Jingbing Wang
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Transcatheter Arterial Chemoembolization ◽  
Clinical Effects ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Embolic Material ◽  
Cesarean Scar ◽  
Severe Hemorrhage ◽  
Arterial Chemoembolization

Objectives. This study observes therapeutic efficacy of uterine artery embolization combined with MTX infusion which terminates cesarean scar pregnancy (CSP) and induces three factors which probably relate to failure.Methods. Twenty-three CSP patients were treated with combined uterine artery MTX infusion and embolization. Among them six patients with severe hemorrhage were immediately treated with interventional operation. Clinical effects were estimated by symptoms, serum -hCG, ultrasound, and MR.Results. Interventional treatments were technologically successful in 22 patients except one. Immediate hemostasis was achieved in all 6 patients with massive colporrhagia. No occurrence of infection and uterine necrosis was observed, but 12 women suffered abdominal pains. Nineteen patients’ uteri were preserved, whereas four underwent hysterectomy eventually.Conclusions. Transcatheter arterial chemoembolization is effective to treat high-risk CSP in preference to hysterectomy. To achieve more successful outcomes, three factors should be highlighted: adequate MTX dosage, appropriate embolic material, and complete embolization of target arteries that supply blood to embryo in the scar.

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 Management of Cesarean Scar Pregnancy: A Single-Institution Retrospective Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
P. Giampaolino ◽  
N. De Rosa ◽  
I. Morra ◽  
A. Bertrando ◽  
A. Di Spiezio Sardo ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Ultrasound Guidance ◽  
Expectant Management ◽  
Artery Embolization ◽  
Maternal Complications ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration

Objective. Cesarean scar pregnancy (CSP) is a rare condition that occurs when the pregnancy implants in a cesarean scar. An early diagnosis and a proper management are fundamental to prevent maternal complications. We review and discuss the different treatment employed in our unit to reduce morbidity, preserve fertility, and predict possible complications. Methods. The reported treatment has been expectant management, operative hysteroscopy approach, and intramuscular injection of 50 mg methotrexate (MTX), followed by cervical dilation and manual vacuum aspiration (D&S) with a Karman cannula under ultrasound guidance, uterine artery embolization (UAE), and manual vacuum aspiration under ultrasound guidance and uterine artery embolization before surgical laparotomic resection. Results. Complications were more frequent in women with a history of three or more cesarean section deliveries and with a myometrial thickness thinner than 2 mm. MTX and D&S treatment appear to be most effective and safe at the early age of pregnancy, while UAE and D&S are related to the highest risk of complication in any age of pregnancy. Conclusion. An appropriate preoperative diagnostic evaluation, the identification of cases at higher risk, and those eligible for a conservative treatment are fundamental to reduce complications.

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