Transvaginal Ultrasound-Guided Embryo Aspiration Plus Local Administration of Low-Dose Methotrexate for Caesarean Scar Pregnancy

This study evaluated the effect of transvaginal ultrasound-guided embryo aspiration plus local administration of low-dose methotrexate (MTX) on caesarean scar pregnancy (CSP). Sixty-eight cases of CSP were randomly grouped for (1) systemic administration of MTX plus curettage with hysteroscopy (control group); and (2) transvaginal ultrasound-guided embryo aspiration plus local administration of low-dose MTX (experimental group). Serum β-HCG and transaminase levels, length of hospital stay, occurrence of hypoleukocytosis, vaginal bleeding and genital infection were analyzed. No statistical differences in the duration needed for β-HCG normalization, genital infection and length of hospital stay were observed between the two groups. However, the occurrence of massive vaginal bleeding, hypoleukocytosis and elevated transaminase levels were significantly lower in patients who received transvaginal ultrasound-guided embryo aspiration plus local administration of low-dose MTX compared with patients in the control group. Our study suggested that transvaginal ultrasound-guided embryo aspiration plus local administration of low-dose MTX should be recommended as a safe and effective treatment of caesarean scar pregnancy.