دورية أكاديمية

Comparison of different treatment strategies in the management of endogenic caesarean scar pregnancy: a multicentre retrospective study

التفاصيل البيبلوغرافية
العنوان: Comparison of different treatment strategies in the management of endogenic caesarean scar pregnancy: a multicentre retrospective study
المؤلفون: Qu, Wenjie, Li, Hua, Zhang, Teng, Zhang, Yuan, Ban, Yanli, Li, Ningfeng, Jiang, Jingyan, Xie, Juan, Shi, Wentian, Hao, Yiping, Li, Ruowen, Liu, Wei, Cui, Baoxia
المصدر: BMC Pregnancy and Childbirth ; volume 22, issue 1 ; ISSN 1471-2393
بيانات النشر: Springer Science and Business Media LLC
سنة النشر: 2022
مصطلحات موضوعية: Obstetrics and Gynecology
الوصف: Background The aim of this study was to evaluate the effectiveness and safety of different treatment strategies for endogenic caesarean scar pregnancy (CSP) patients. Methods According to Vial’s standard, we defined endogenic-type CSP as (1) the gestational sac growing towards the uterine cavity and (2) a greater than 0.3 cm thickness of myometrial tissue at the caesarean scar. A total of 447 endogenic CSP patients out of 527 patients from 4 medical centres in China were enrolled in this study. A total of 120 patients were treated with methotrexate (MTX) followed by surgery, 106 received ultrasound-guided curettage directly and 221 received curettage combined with hysteroscopy. The clinical information and clinical outcomes of these patients were reviewed. Successful treatment was defined as (1) no additional treatment needed, (2) no retained mass of conception and (3) serum β subunit of human chorionic gonadotropin (β-hCG) level returning to a normal level within 4 weeks. The success rate was analysed based on these factors. Result Among 447 patients, no significant difference was observed in baseline characteristics between groups except for foetal heartbeat. The success rate was significantly different ( p <0.001) among the three groups. The highest success rate of 95.9% was noted in the hysteroscopy group, and the lowest success rate of 84.0% was noted in the curettage group. In addition, the MTX group reported the longest hospital stay and highest expenses, but the curettage group showed the shortest and lowest expenses, respectively. Nevertheless, no difference in blood loss was observed between the groups. Conclusion The combination of curettage and hysteroscopy represents the most effective strategy. Pretreatment with MTX did not result in better clinical outcomes. Ultrasound-guided curettage directly should not be considered a first-line treatment choice for endogenic CSP patients.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1186/s12884-022-04633-y
DOI: 10.1186/s12884-022-04633-y.pdf
DOI: 10.1186/s12884-022-04633-y/fulltext.html
الإتاحة: https://doi.org/10.1186/s12884-022-04633-yTest
حقوق: https://creativecommons.org/licenses/by/4.0Test ; https://creativecommons.org/licenses/by/4.0Test
رقم الانضمام: edsbas.2C2B4541
قاعدة البيانات: BASE