scholarly journals Concomitant ultrasound-guided intra-gestational sac methotrexate-potassium chloride and systemic methotrexate injection in the recurrent cesarean scar pregnancy

2016 ◽  
Vol 59 (3) ◽  
pp. 245 ◽  
Author(s):  
Ju Hak Lee ◽  
Dae Hui Kwon ◽  
Ki Hoon Ahn ◽  
Soon Cheol Hong ◽  
Tak Kim
Keyword(s):  
Potassium Chloride ◽  
Ultrasound Guided ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Gestational Sac

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.

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.

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

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

scholarly journals Cesarean Scar Pregnancy - A Rare Entity: Two Case reports

2018 ◽  
Vol 2 (3) ◽  
pp. 312-315
Author(s):  
Krishna Mahato ◽  
Yu Bin
Keyword(s):  
Maternal Morbidity ◽  
Case Reports ◽  
Rare Entity ◽  
Ultrasound Guided ◽  
Management Options ◽  
Cesarean Scar Pregnancy ◽  
Major Hemorrhage ◽  
Cesarean Scar ◽  
Presenting Symptoms ◽  
Life Threatening

Cesarean scar pregnancy is the implantation of an embryo within the mymometrium of prior cesarean scar which is a rare variant of ectopic pregnancy. Such implantation is life threatening leading to uterine rupture, extensive hemorrhage and serious maternal morbidity. Making an early diagnosis minimizes risk of such major hemorrhage thus preserving the uterus and further fertility. In this case report we discuss two different management options: ultrasound guided intragestational methotrexate injection with sac aspiration; and transvaginal hysterotomy considering the severity of presenting symptoms. Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 312-315

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.

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