Different Surgical Approaches to 313 Cesarean Scar Pregnancies

Journal of Minimally Invasive Gynecology
Aiwen LeTogas Tulandi

Abstract

To evaluate the efficacy of different surgical treatments for cesarean scar pregnancy (CSP). Retrospective study (Canadian Task Force classification II-3). Affiliated university hospitals. Women (n = 313) with CSP. Dilation and curettage under ultrasound guidance (DCUS, n = 124), dilation and curettage with hysteroscopic guidance (DCH, n = 103), vaginal excision (n = 55), laparotomy (n = 12), and laparoscopy (n = 19). Undetectable serum human chorionic gonadotropin (hCG) levels and thickness of the uterine scar were measured before and after surgery. Success rates of the 5 surgical treatments of CSP (DCUS, DCH, vaginal excision, laparotomy, and laparoscopy) ranged between 89% and 100%. Postoperative treatment was not needed in the vaginal and laparotomy groups, and vaginal treatment was associated with shorter operative time than laparotomy and laparoscopy and shorter time to undetectable hCG levels than DCUS and DCH. Serum hCG levels on day 3 after surgery were significantly lower than baseline levels in all groups of patients, but there was no significant difference between levels on days 3 and 5 postoperatively. Median scar thickness after surgery in the vaginal surgery, laparotomy, and laparoscopy groups was thicker than th...Continue Reading

Citations

May 19, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Maddalena MorlandoFrancesco D'Antonio
Jun 12, 2020·Therapeutics and Clinical Risk Management·Ting-Ting TanZheng-Qiong Chen
Jan 4, 2021·Archives of Gynecology and Obstetrics·Xiaofeng XuHuaijun Zhou
Dec 29, 2020·Contraception·Jessica A ReidAlyssa C Colwill
Jan 24, 2021·Journal of Gynecology Obstetrics and Human Reproduction·Nikolaos KathopoulisAthanasios Protopapas
Mar 3, 2021·Cell and Tissue Research·Neda KeyhanvarRalf Dittrich
Mar 24, 2021·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Qinghua Du, Wancheng Zhao
May 17, 2021·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Jiawen WuShiyuan Wei

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