Methotrexate therapy followed by suction curettage followed by Foley tamponade for caesarean scar pregnancy

Jiang, Tao; Liu, Guipeng; Huang, Ling; Ma, Huanxin; Zhang, Shulan

doi:10.1016/j.ejogrb.2011.01.016

Cited by 45 publications

(25 citation statements)

References 15 publications

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“…Uterine suction curettage under ultrasound guidance as a primary treatment can achieve successful results in selected cases [19], but a review of the literature by Rotas et al [20] showed that only 5/21 (24%) cases managed primarily by uterine dilation and curettage were uncomplicated and required no further treatment. Therefore, various haemostatic measures have been used for the prevention and control of profuse bleeding, such as local injections of vasopressin, intrauterine balloon tamponade using a Foley catheter, or bilateral uterine artery ligation [5,21]. …”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Haemorrhage during Suction Curettage after Uterine Artery Embolization for Treating Caesarean Scar Pregnancy: A Case-Control Study

Zhang

Wang³

2015

Gynecol Obstet Invest

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Aims: To investigate the potential risk factors for haemorrhage during suction curettage after uterine artery embolization (UAE) in the treatment of caesarean scar pregnancy (CSP). Methods: A case-control study was executed including 35 patients with CSP and haemorrhage during suction curettage after UAE and 140 controls without haemorrhage. The data collected included gestational age, the distance between the gestational mass and the bladder, and the volume of vaginal bleeding. Results: Six patients with UAE needed blood transfusions and two had a hysterectomy, while no patient in the control group needed these interventions. Multivariate analysis showed that both gestational age and the distance between the gestational mass and the bladder were associated with haemorrhage in the CSP group. The odds ratio (OR) of gestational age between cases and controls was 1.579 (95% confidence interval [CI] 1.291-1.933), and the OR of the distance between the gestational mass and the bladder was 0.208 (95% CI 0.082-0.531). Conclusion: Increased gestational age might be an important risk factor for haemorrhage during suction curettage after UAE in the treatment of patients with CSP, and a distance of >0.2 cm between the gestational mass and the bladder was protective against haemorrhage.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Haemorrhage during Suction Curettage after Uterine Artery Embolization for Treating Caesarean Scar Pregnancy: A Case-Control Study

Zhang

Wang³

2015

Gynecol Obstet Invest

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“…Les pertes rapporté es sont largement supé rieures à celles observé es dans notre pratique et traduisent l'inté rêt des straté gies thé rapeutiques combiné es. Ainsi Jiang et al [16], parmi 45 patientes traité es par MTX en IM ou in situ (en cas d'activité cardiaque pré sente), associent dans le cadre d'une straté gie combiné e l'A&C avec la pose d'une sonde de tamponnement type Foley au 8 e jour aprè s l'injection de MTX. Les pertes sanguines quantifié es selon la même technique employé e par Wang et al [15] sont de 706 mL avec un succè s complet du traitement conservateur.…”

Section: Discussionunclassified

“…En cas de traitement mé dical par MTX, sa mise en place est avant tout pré ventive avec un positionnement intra-uté rin de 2 à 6 jours. En straté gie thé rapeutique combiné e son positionnement immé diatement aprè s procé dure d'A&C sous contrôle é chographique en regard du site de la cicatrice permet un contrôle de l'hé mostase et la pré servation de la fertilité [16,32].…”

Section: Discussionunclassified

Grossesse sur cicatrice de césarienne : traitement combiné avec embolisation des artères utérines avant procédure chirurgicale

Gall

Fichez

Lamblin

et al. 2015

Gynécologie Obstétrique & Fertilité

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“…18) In addition, the present hemostasis results using small metreurynters are consistent with previous studies showing the effectiveness of Foley balloon catheters for local treatment of CSP and CP. 19,20) With regard to the volume of balloon inflation, different volumes have been reported depending on balloon shape: Bakri, 500 ml; 21) Sengstaken-Blakemore, 120-370 ml;…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effectiveness of metreurynters for balloon tamponade

Yorifuji

Takeda

Makino

et al. 2018

Hypertens Res Pregnancy

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Aim: Several devices are used for balloon tamponade. In Japan, metreurynters are widely used for cervical ripening; however, there is little evidence for their use in hemostatic uterine balloon tamponade. This study aimed to assess the non-inferiority of metreurynters as the balloon device for obstetric hemorrhage. Methods: Medical charts of all patients with obstetric hemorrhage of more than 1,000 ml who underwent balloon tamponade with metreurynters were retrospectively reviewed for five years at a tertiary referral university hospital. Results: A total of 89 uterine balloon tamponade cases were identified from medical records. Of these, 66 cases involved term postpartum hemorrhage (PPH) within 24 h after delivery (PPH group) and 23 involved other types of cases (other group), including cesarean scar pregnancy, cervical pregnancy, retained placenta, and others. In the PPH group, the average hemostasis rate was 93.9%, whereas the rate was 91.3% in the other group. Seven cases failed to achieve hemostasis with balloon tamponade only and required additional treatment. There were no adverse events related to balloon tamponade using metreurynters. Conclusions: Metreurynters used for balloon tamponade were non-inferior to Bakri balloons in hemostasis and complication rates, suggesting they are effective and appropriate for the management of obstetrical hemorrhage.

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Methotrexate therapy followed by suction curettage followed by Foley tamponade for caesarean scar pregnancy

Cited by 45 publications

References 15 publications

Risk Factors for Haemorrhage during Suction Curettage after Uterine Artery Embolization for Treating Caesarean Scar Pregnancy: A Case-Control Study

Risk Factors for Haemorrhage during Suction Curettage after Uterine Artery Embolization for Treating Caesarean Scar Pregnancy: A Case-Control Study

Grossesse sur cicatrice de césarienne : traitement combiné avec embolisation des artères utérines avant procédure chirurgicale

Evaluation of the effectiveness of metreurynters for balloon tamponade

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