Chinese Medical Sciences Journal ›› 2015, Vol. 30 ›› Issue (4): 226-230.

• Original Article • Previous Articles     Next Articles

Management of Cesarean Scar Pregnancy: A Case Series

Min-hui Guo1, 2, Mei-fen Wang2, Man-man Liu2, Feng Qi2, Fan Qu1, Jian-hong Zhou1   

  1. 1.Department of Gynecology and Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China;
    2.Department of Gynecology and Obstetrics, Taizhou Hospital of Zhejiang Province, Taizhou 317000, Zhejiang, China
  • Received:2015-03-10 Published:2015-12-20 Online:2015-12-20

Objective To survey effective treatment strategies for cesarean scar pregnancy (CSP).Methods The clinical data of 78 patients diagnosed with CSP from January 2010 to December 2013 were reviewed.Results Among these patients, 17 patients were first treated at our hospital; of them, 2 were misdiagnosed. The other 61 patients were referred from other hospitals; of them, 21 were initially misdiagnosed. There were 9 patients who were treated with laparotomy, 50 patients with curettage after uterine artery embolization (UAE) with or without local methotrexate (MTX) infusion, 10 patients with dilatation and curettage, 6 patients with transvaginal sonographic guided local intragestational MTX injection, and 3 patients with systemic MTX injection. All patients finally recovered. Patients with excessive vaginal hemorrhage underwent either emergency UAE treatment or laparotomy. These two treatments had similar success rates (81.82% vs. 100%, χ2 =0.289, P>0.05).Conclusions The accurate diagnosis of CSP is important. Curettage after UAE with or without local MTX infusion is a safe and effective method.

Key words: cesarean scar pregnancy, transvaginal ultrasound, curettage, uterine artery embolization, laparotomy

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