Incorporating uterine artery embolization in the treatment of cesarean scar pregnancy following diagnostic ultrasonography

ObjectiveTo evaluate combining uterine artery embolization (UAE) with other treatments for cesarean scar pregnancy (CSP).MethodsA retrospective study included patients attending the First affiliated Hospital of Xi'an Jiaotong University, China, between March 1, 2009 and March 31, 2014, who were diagnosed with CSP. Patients were classified by ultrasonography as having endogenous CSP (CSP type I [CSP-I]) or exogenous CSP (CSP type II [CSP-II]). Patient outcomes were compared between patients who underwent treatment that included or excluded UAE. Patient records were reviewed and patients were interviewed by telephone to report on recovery following treatment.ResultsIn total, 52 patients met the inclusion criteria. In patients with CSP-I, the blood loss, length of hospital stay, and time before restoration of normal β human chorionic gonadotropin levels were significantly higher in patients who were treated with methotrexate combined with dilatation and curettage compared with those treated with UAE combined with dilatation and curettage (P < 0.05). In patients with CSP-II, blood loss was lower in patients treated with UAE combined with excision compared with excision alone (P < 0.001).ConclusionIncorporating UAE in the treatment of CSP-I and CSP-II was safe; CSP should be properly classified to select the appropriate treatment.