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.

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 

2020 ◽  
Vol 9 (2) ◽  
pp. 45-48
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

Aim: To evaluate the efficacy and safety of single dose of of Systemic MTX 50 mg/m2 followed by D&S in cases of Cesarean scar pregnancy (CSP). 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 the 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 preceded 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 gestational age of pregnancy was 8.5±1.6. The mean level of serum b-human chorionic gonadotrophin was (7424±2.560). 88.7% was the successive rate without complication or need of 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.

Molar Pregnancy in Cesarean Section Scar: A Case Report and Literature Review

2020 ◽  
Author(s):  
Mine Daggez ◽  
Mehmet Dolanbay
Keyword(s):  
Ultrasound Guidance ◽  
Case Reports ◽  
Hydatidiform Mole ◽  
Rare Condition ◽  
Molar Pregnancy ◽  
Resonance Imaging ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Suction Curettage ◽  
Magnetic Resonance Imaging Mri

AbstractMolar pregnancy in cesarean scar is an extremely rare condition. It has a high risk of uterine rupture and bleeding. There is a small number of case reports in the literature, so the optimal diagnostic algorithms and management are not clear. We reported a 25-year-old woman who presented to our clinic with amenorrhea for 40 days and vaginal bleeding for 3 days. Transvaginal ultrasonography and serum human chorionic gonadotropin (hCG) level raised suspicion of a molar cesarean scar pregnancy (CSP). Magnetic resonance imaging (MRI) was conducted for further knowledge of the characteristics of the mass. Careful suction curettage under ultrasound guidance was performed. The histologic examination of the tissue confirmed a partial hydatidiform mole. The differential diagnosis between CSP and molar CSP is extremely challenging. Serum hCG, sonogram, and MRI are our tools, but none of them suffice for a definitive diagnosis. Histological examination of the postoperative sample is still the gold standard for the diagnosis of molar CSP; however, MRI can assist in planning the necessary interventions.

scholarly journals Evaluation of the Treatment of High Intensity Focused Ultrasound Combined With Suction Curettage for Exogenous Cesarean Scar Pregnancy

2021 ◽  
Author(s):  
Lin Mu ◽  
Huifang Weng ◽  
Xiaoyun Wang
Keyword(s):  
Blood Loss ◽  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Control Group ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Suction Curettage ◽  
Gestational Sac ◽  
The Mean

Abstract Purpose: To evaluate the effectiveness of high intensity focused ultrasound (HIFU) combined with suction curettage in the treatment of exogenous cesarean scar pregnancy (CSP). Methods: A total of 41 patients diagnosed with exogenous CSP were enrolled in this study. All patients received HIFU treatment combined with suction curettage. Results: Twenty-nine patients were administered one session of HIFU ablation. In addition, the other 12 patients received 2 HIFU sessions. Suction curettage was performed in all patients after HIFU, and no patient was converted to laparoscopy or hysterectomy. The mean blood loss during suction curettage was 99 ml. Three patients received two sessions of suction curettage. The success rate of our study was 92.68%. The mean time for serum β-HCG normalization was 23.18±3.13 days. The average menstruation recovery time was 29.38±3.34 days. Based on the blood loss during suction curettage, 41 patients were divided into a bleeding group and a control group. The size of the gestational sac in the bleeding group (3.80±0.87 cm) was larger than that in the control group (3.39±0.77 cm) (P <0.05). The thickness of the myometrium between the bladder and gestational sac in the bleeding group (2.37±0.89 mm) was less than that in the control group (2.75±0.75 mm) (P <0.05). Conclusion: The results suggested that HIFU combined with suction curettage could be considered an effective treatment for exogenous CSP of < 9 weeks. The size of the gestational sac and the thickness of the myometrium between the bladder and gestational sac might be high-risk factors for blood loss during this treatment.

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.

scholarly journals High-Intensity Focused Ultrasound Combined With Suction Curettage for the Treatment of Cesarean Scar Pregnancy

Medicine ◽  
2015 ◽  
Vol 94 (18) ◽  
pp. e854 ◽  
Author(s):  
Xiaogang Zhu ◽  
Xinliang Deng ◽  
Yajun Wan ◽  
Songshu Xiao ◽  
Jiping Huang ◽  
...  
Keyword(s):  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Suction Curettage

Management of cesarean scar pregnancy with suction curettage: a report of four cases and review of the literature

2014 ◽  
Vol 289 (6) ◽  
pp. 1171-1175 ◽  
Author(s):  
Yeşim Bayoglu Tekin ◽  
Ulku Mete Ural ◽  
Gulşah Balık ◽  
Isık Ustuner ◽  
Figen Kır Şahin ◽  
...  
Keyword(s):  
Review Of The Literature ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Suction Curettage

scholarly journals Role of collateral embolization in addition to uterine artery embolization followed by hysteroscopic curettage for the management of cesarean scar pregnancy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guodong Zhang ◽  
Jijun Li ◽  
Jun Tang ◽  
Lei Zhang ◽  
Dechao Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Pelvic Pain ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
The Mean ◽  
Baseline Characteristics ◽  
Β Hcg

Abstract Background The aim of this study was to assess the feasibility, safety and outcome of the embolization of non-gonadal collateral supplying gestational sac (GS) in addition to uterine artery embolization (UAE), followed by hysteroscopic curettage for the management of cesarean scar pregnancy (CSP). Methods A retrospective study was undertaken from January 2012 to September 2018 in 24 CSP patients in whom non-gonadal collaterals supplying GS were identified by arterial angiography performed immediately after UAE. These patients underwent attempt collateral embolization in addition to UAE, followed by hysteroscopic curettage for the management of CSP. The 24 patients were divided into two groups based on whether they underwent technically successful collateral embolization (UAE-SCE group) or failed collateral embolization (UAE-FCE group) in addition to UAE. The baseline characteristics and clinical outcomes including time for serum β-human chorionic gonadotropin (β-hCG) levels normalization, blood loss, secondary anemia, and pelvic pain were compared between the two groups. The paired t test and Man Whitney test were used for comparisons of discrete and numerical variables, respectively. Results Collateral embolization was techinically successful in 16 (66.7%, 16/24) patients and failed in the other 8 (33.3%, 8/24) patients. There were no significant differences between the two groups in baseline characteristics. The mean blood loss and secondary anemia in the UAE-SCE group were significantly less than UAE-FCE group. No significant difference was found between the two groups in the mean time for β-hCG levels normalization and pelvic pain. Conclusions During the management of UAE combined with hysteroscopic curettage for CSP, additional embolization of non-gonadal collateral supplying GS during UAE is feasible and safe in patients with non-gonadal collateral supplying GS, and the additional embolization of the collateral may reduce blood bloss related to hysteroscopic curettage.

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