Exogenous cesarean scar pregnancies managed by suction curettage alone or in combination with other therapeutic procedures: A series of 33 cases and analysis of complication profile

Özdamar, Özkan; Döğer, Emek; Arlıer, Sefa; Çakıroğlu, Yiğit; Ergin, Rahime Nida; Köpük, Şule Yıldırım; Çalışkan, Eray

doi:10.1111/jog.13017

Cited by 18 publications

(12 citation statements)

References 32 publications

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“…In this observational study, only one patient (2.3%) manifested uterine rupture after curettage and 4 (9%) patients revealed persistent bleeding during the procedure. Although the rate of uterine ruptures was consistent with the literature 15 , the persistent bleeding rate was lower in our study compared with the literature 33 . This lower rate may have resulted from appropriate patient selection, surgical experience or the surgical technique we performed.…”

Section: Discussionsupporting

confidence: 91%

The effect of ultrasound-guided suction curettage on reproductive outcomes in patients with cesarean scar pregnancy

Sucu

2021

Dicle Tıp Dergisi

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Objective: This study aims to evaluate reproductive and pregnancy outcomes in patients with cesarean scar pregnancies (CSP) treated by suction curettage.Methods: This retrospective observational study included 85 patients with CSP treated by suction curettage in a university hospital between 2013-2017. Reproductive status of the patients who could be reached by phone was inquired at 6-month intervals for three years.Results: Hospital records and telephone follow-up data of the 44 patients who completed follow-up were analyzed. Nineteen patients did not desire pregnancy, while 25 patients reported wishing to conceive again. Twenty-three of these patients (92%, 23/25) conceived spontaneously, 2 of them (8%, 2/25) unable to conceive due to unexplained secondary infertility. Mean length of time from CSP to subsequent pregnancy was 12.3 months (range 2-36 months). Of these pregnancies, 11 (47.8%, 11/23) resulted in birth without any obstetrical problems. Six patients (26%, 6/23) experienced miscarriage, and three patients (13%, 3/23) recurrent cesarean scar pregnancies. Two patients (8.6%, 2/23) had abnormal placental invasion and one patient (4.3%, 1/23) tubal ectopic pregnancy. The live birth rate among the pregnancies was 52.1% (12/23). Conclusion:There is no consensus on the primary treatment regarding the reproductive outcomes. Suction curettage is a successful, reliable, inexpensive and easily applicable treatment when appropriate patients are selected. Furthermore, it has a minimal negative effect on fertility, so it can be considered as a first-line treatment option in patients who wish to have children in the future.

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Section: Discussionsupporting

confidence: 91%

The effect of ultrasound-guided suction curettage on reproductive outcomes in patients with cesarean scar pregnancy

Sucu

2021

Dicle Tıp Dergisi

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“…Our multiple logistic regression analysis showed an association between the success rate and the primary treatment options. Treatment by uterine curettage showed a success rate of 48% [reviewed in ( 14 )] and it should be performed when the serum β-hCG level is <50 IU/L without blood flow velocity ( 15 ) or in type 1 caesarean scar pregnancy ( 16 ). In our current study, we found that the overall success rate by uterine curettage was 70% and there was no difference in the levels of β-hCG in cases who received three different options of treatment.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Treatment Options for Type 1 and Type 2 Caesarean Scar Pregnancy: A Retrospective Case Series Study

Shen¹,

Lv²,

Wang³

et al. 2021

Front. Med.

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Background: There is currently no agreement on the optimal management of caesarean scar pregnancy. Caesarean scar pregnancy is currently categorised into two subtypes according to the site of implantation. This may consequently result in the difference in treatment options. However, the comparison of the success rate of each treatment option according to the subtypes has not been fully investigated.Methods: 71 patients who were treated by uterine curettage (D and C), or uterine artery embolization with curettage (UAE) or hysteroscopy in conjunction with laparoscopy between January 2016 and March 2020 were included. Data on maternal age, gestational sac age, the sac diameter, the interval between two pregnancies, the number of previous caesarean sections, amount of bleeding and β-hCG levels were collected and analysed dependent on the subtypes.Results: There was no difference in the clinical parameters of the cases who received different options of treatment, as well as no difference in the clinical parameters between type 1 and type 2 caesarean scar pregnancy. The primary success rate for type 1 caesarean scar pregnancy by D and C, or UAE, or hysteroscopy in conjunction with laparoscopy was 95, or 100 or 100%, respectively. The primary success rate for type 2 caesarean scar pregnancy by D and C, or UAE, or hysteroscopy in conjunction with laparoscopy was 27, or 67, or 95% respectively.Conclusion: Our data demonstrates that hysteroscopy in conjunction with laparoscopy for type 2 caesarean scar pregnancy was the most successful compared to other options, but for type 1 caesarean scar pregnancy, D and C could be the cost-effective option.

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“…Özkan Özdamar et al demonstrated that in appropriate CSP cases, ultrasound-guided suction curettage appears to be a reliable treatment option. [ 12 ]. Jurkovic D. also considered suction curettage as an effective method for the treatment of CSP which was associated with a lower risk of blood transfusion and hysterectomy [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Caesarean scar pregnancy with or without methotrexate before curettage: human chorionic gonadotropin trends and patient outcomes

Wang

Beejadhursing

et al. 2018

BMC Pregnancy Childbirth

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BackgroundTo evaluate the effects of systemic methotrexate in cesarean scar pregnancy (CSP) patients treated with ultrasound-guided suction curettage.MethodsA retrospective review of all women presenting with CSP treated with ultrasound-guided suction curettage at Tongji Hospital, Wuhan, China, between January 1, 2013 and December 31, 2015, was conducted. Patients were grouped into those not treated with methotrexate before curettage (group 1), treated with methotrexate by intramuscular injection (group 2) and treated with methotrexate by intravenous injection (group 3). The clinical characteristics and outcomes were analyzed.ResultsAmong 107 patients, 47 patients were not treated with methotrexate before curettage, 46 patients had methotrexate administered by intramuscular injection and 14 patients had methotrexate injected intravenously. There were no significant differences among the groups in basic and clinical characteristics, such as age, gravity, parity, positive fetal heart beat and gestational age at diagnosis. Patients presented similar initial human chorionic gonadotropin (hCG) levels in all groups. After treatment with methotrexate or curettage, the percentage changes and varied ranges of the hCG levels were also similar in all groups. There were no significant differences in intraoperative blood loss and retained products of conception among the three groups. However group 1 had significantly shorter hospital stays than the two groups that were treated with methotrexate (p<0.001).ConclusionBy grouping CSP patients who shared similar age, gravity, parity, fetal heart beat positive and gestational age at diagnosis, we found that the presence or absence of methotrexate treatment before curettage resulted in comparable outcomes and hCG levels, although patients who were not treated with methotrexate had significantly shorter stays in the hospital.

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Exogenous cesarean scar pregnancies managed by suction curettage alone or in combination with other therapeutic procedures: A series of 33 cases and analysis of complication profile

Abstract: In appropriate CSP cases, TAUS-guided suction curettage appears to be a reliable treatment option with acceptable success rates and similar complication profile to other therapeutic options.

Cited by 18 publications

References 32 publications

The effect of ultrasound-guided suction curettage on reproductive outcomes in patients with cesarean scar pregnancy

The effect of ultrasound-guided suction curettage on reproductive outcomes in patients with cesarean scar pregnancy

A Comparison of Treatment Options for Type 1 and Type 2 Caesarean Scar Pregnancy: A Retrospective Case Series Study

Management of Caesarean scar pregnancy with or without methotrexate before curettage: human chorionic gonadotropin trends and patient outcomes

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