Bilateral uterine artery chemoembolization combined with dilation and curettage for treatment of cesarean scar pregnancy: A method for preserving the uterus

• Published in: The journal of obstetrics and gynaecology research Vol. 39; no. 6; pp. 1153 - 1158
• Main Authors: Lan, Weishun, Hu, Daoyu, Li, Zhen, Wang, Liang, Yang, Wenzhong, Hu, Shan
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-06-2013
• Subjects: Adult; Angiography; cesarean scar pregnancy; Cesarean Section - adverse effects; Cicatrix - complications; Dilatation and Curettage; dilation and curettage; Female; Humans; methotrexate; Pregnancy; Pregnancy Complications - diagnostic imaging; Pregnancy Complications - etiology; Pregnancy Complications - surgery; Retrospective Studies; uterine artery chemoembolization; Uterine Artery Embolization; Young Adult
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.12051

Aim
The aim of this study was to respectively evaluate the feasibility and safety of bilateral uterine artery chemoembolization (UACE) combined with dilation and curettage (D&C) for the treatment of cesarean scar pregnancy (CSP).
Material and Methods
Our study was approved by our institutional review board, with informed patient consent. From January 2004 to December 2010, 79 patients with CSP underwent UACE in our institution, with transcatheter infusion of 30–50 mg methotrexate into the bilateral uterine artery before embolization with sponge particles. Within 24–48 h after UACE, D&C was performed on all the patients under the guidance of ultrasonography and hysteroscopy.
Results
All the 79 patients diagnosed as having CSP were included in our study and their data were analyzed. All the patients recovered completely without severe complications. The average hemorrhage volume during D&C was 30 mL, but none of them needed transfusion. The uteri of all the patients were preserved, and none of them had to undergo hysterectomy. The safety rate was 100%. The mean duration of hospital stay was 10.5 days.
Conclusions
UACE performed prior to D&C is a feasible method and it may reduce hemorrhage complications and risk of hysterectomy in patients with CSP.