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

摘要

Objective: To assess the efficacy of uterine artery embolization (UAE) combined with dilation and curettage (D and C) within 24 hours for the treatment of a cesarean scar pregnancy (CSP), compared with methotrexate and D and C.Methods: A retrospective cohort study of 119 women with CSP was conducted at two tertiary hospitals in Guangzhou and Shenzhen, China, during 20092012. Twenty-six women received systemic methotrexate followed by D and C, and 93 women were treated with UAE followed by D and C within 24 hours.Results: Mean blood loss was 261.0 ± 357.4 mL in the methotrexate group versus 14.1 ± 40.6 mL in the UAE group (P < 0.001). The time to resolution of the level of β-human chorionic gonadotropin was 40.5 ± 17.2 days versus 15.4 ± 7.7 days (P b 0.001), respectively. The duration of ospitalization was 14.6 ± 9.2 days versus 6.2 ± 3.7 days (P b 0.001), respectively. An additional intervention was needed in 9 (35%) women in themethotrexate group and in 5 (5%) in the UAE group (P < 0.001).Conclusion: UAE combinedwith D and C within 24 hours 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 and C.