Comparison of transvaginal surgery and methotrexate/mifepristone-combined transcervical resection in the treatment of cesarean scar pregnancy

Eur Rev Med Pharmacol Sci. 2017 Jun;21(12):2957-2963.

Abstract

Objective: To explore the safety and efficiency of transvaginal surgical treatment of cesarean scar pregnancy (CSP).

Patients and methods: A retrospective analysis of 54 CSP patients that received treatment in our hospital from October 2011 to September 2015 was performed, dividing two groups: Group A (n=34) received transvaginal cesarean scar pregnancy focus clearance surgery while Group B (n=20) received transcervical resection following methotrexate/mifepristone-combined treatment. The basic clinical findings were collected and analyzed, along with the curative effects between the two groups.

Results: Differences in age (30.91 ± 4.59 years vs. 31.91 ± 5.53 years) for gravidity (2.97 ± 1.24 times vs. 2.75 ± 1.48 times), cesarean section (1.24 ± 0.43 vs. 1.20 ± 0.41), time interval from last cesarean section (56.53 ± 32.93 months vs. 58.70 ± 39.44 months), menelipsis (51.35 ± 10.90 days vs. 57.85 ± 16.62 days), pre-operative serum-hCG (27953.65 ± 37517.10 mIU/L vs. 17368.24 ± 35094.14 mIU/L), operation time (43.34 ± 12.38 min vs 40.07 ± 16.88 min), menstruation recovery time (1.23 ± 0.53 months vs. 1.55 ± 0.76 months) were not statistically significant (p > 0.05). The differences in the intraoperative blood loss (43.34 ± 12.38 ml vs. 40.07 ± 16.88 ml), average hospital stay (7.61 ± 2.47 days vs. 12.42 ± 3.64 days), time for β-hCG to return to normal (18.50 ± 8.19 mIU/L vs. 29.00 ± 12.96 mIU/L) between the two groups were statistically significant (p < 0.05). Group A was significantly lower than Group B.

Conclusions: Transvaginal surgery is an effective and relatively safe treatment option for CSP patients.

MeSH terms

  • Adult
  • Blood Loss, Surgical
  • Cesarean Section*
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Cicatrix / complications*
  • Female
  • Humans
  • Length of Stay
  • Methotrexate / administration & dosage
  • Methotrexate / therapeutic use*
  • Mifepristone / administration & dosage
  • Mifepristone / therapeutic use*
  • Operative Time
  • Pregnancy
  • Pregnancy, Ectopic / etiology
  • Pregnancy, Ectopic / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Uterine Artery Embolization

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • Mifepristone
  • Methotrexate