Uterine artery embolization followed by dilation and curettage within 24 hours compared with systemic methotrexate for cesarean scar pregnancy

Abstract

ObjectiveTo assess the efficacy of uterine artery embolization (UAE) combined with dilation and curettage (D&C) within 24hours for the treatment of a cesarean scar pregnancy (CSP), compared with methotrexate and D&C. MethodsA retrospective cohort study of 119 women with CSP was conducted at two tertiary hospitals in Guangzhou and Shenzhen, China, during 2009–2012. Twenty-six women received systemic methotrexate followed by D&C, and 93 women were treated with UAE followed by D&C within 24hours. ResultsMean blood loss was 261.0±357.4mL in the methotrexate group versus 14.1±40.6mL in the UAE group (P<0.001). The time to resolution of the level of β-human chorionic gonadotropin was 40.5±17.2days versus 15.4±7.7days (P<0.001), respectively. The duration of hospitalization was 14.6±9.2days versus 6.2±3.7days (P<0.001), respectively. An additional intervention was needed in 9 (35%) women in the methotrexate group and in 5 (5%) in the UAE group (P<0.001). ConclusionUAE combined with D&C within 24hours was an effective uterine preservation treatment for CSP, and was associated with less blood loss and a shorter hospital stay than administration of methotrexate followed by D&C.