Study of individualization therapy for 61 patients with cesarean scar pregnancy

Abstract

To investigate the clinical value of the individualization therapy for cesarean scar pregnancy (CSP).According to the individual characteristics of the CSP in 61 patients admitted and treated by the People's Hospital of Yuyao City, China between March 2010 and February 2013, methotrexate (MTX) with leucovorin (CF) or uterine artery chemotherapy embolization (UACE) were used to kill the embryos, stanch, and prevent bleeding. Guided by hysteroscopy or B ultrasound, uterine curettage was carried out under the surveillance of laparoscopy if necessary.Fifty-four cases of patients were treated by UACE. MTX with CF was used,in seven cases. Uterine curettage was performed in 44 cases under the guidance of hysteroscopy. Six cases were under the surveillance of the B ul- trasound and both hysteroscopic guidance and B ultrasound surveillance were used in seven cases. The lesions disappeared in two cases after transabdominal excision and two cases after UACE. All of the 61 patients were cured without hysterectomy.Selection of individualization treatment programs according to the characteristics of the disease could improve the efficacy and prognosis of patients with CSP. The appropriate timing to perform curettage was five to seven days after embryo killing in order to reduce bleeding and shorten the course of the disease.