Uterine Artery Embolization Combined with Dilation and Curettage for the Treatment of Cesarean Scar Pregnancy: Efficacy and Future Fertility

Cardiovasc Intervent Radiol. 2018 Aug;41(8):1165-1173. doi: 10.1007/s00270-018-1934-z. Epub 2018 Mar 15.

Abstract

Purpose: To investigate the efficacy and safety of uterine artery embolization (UAE) followed by dilation and curettage (D&C) as a treatment for cesarean scar pregnancy (CSP) and to assess pregnancy outcomes after the treatment.

Materials and methods: We retrospectively analyzed 33 CSP patients treated with UAE followed by D&C. The serum level of beta human chorionic gonadotropin (β-hCG) normalization, hospitalization, menstruation, and successful pregnancy after treatment was assessed as clinical and pregnancy outcomes.

Results: A total of 33 patients were initially treated without severe complications. However, four patients required additional systemic chemotherapy. β-hCG normalization took 35.5 ± 14.9 days (range 13-79), and the hospitalization was 6.5 ± 2.5 days (2-15). All patients resumed normal menstruation after 36 ± 19.2 days (12-86). Of 16 of 33 patients who desired pregnancy after the treatment, seven patients (43.8%) had uneventful parturition.

Conclusions: UAE combined with D&C was efficient and safe for CSP management. This minimally invasive procedure may be considered as one of the treatment options which enable preservation of fertility after treatment.

Keywords: Cesarean scar pregnancy; Dilation and curettage; Fertility; Pregnancy outcomes; Uterine artery embolization.

MeSH terms

  • Adult
  • Cesarean Section*
  • Cicatrix
  • Combined Modality Therapy / methods
  • Dilatation and Curettage / methods*
  • Female
  • Fertility*
  • Humans
  • Methotrexate / administration & dosage
  • Pregnancy
  • Pregnancy, Ectopic / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Uterine Artery Embolization / methods*

Substances

  • Methotrexate