Imperial College London
Alternate

ProfessorMarkJohnson

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Chair in Obstetrics
 
 
 
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Contact

 

+44 (0)20 3315 7887mark.johnson

 
 
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Location

 

H3.35Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Feng:2016:10.3892/etm.2016.3489,
author = {Feng, Y and Chen, S and Li, C and Zhang, X and Duan, H and Sooranna, S and Johnson, MR and Li, J},
doi = {10.3892/etm.2016.3489},
journal = {Experimental and Therapeutic Medicine},
pages = {1469--1475},
title = {Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy.},
url = {http://dx.doi.org/10.3892/etm.2016.3489},
volume = {12},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - In the present study, we evaluated the diagnosis and management modalities of caesarean scar pregnancy (CSP). Thirty patients diagnosed with CSP were retrospectively studied between February, 2010 and February, 2012. Twenty-five patients were offered prophylactic uterine artery embolization (UAE) and methotrexate (MTX) prior to uterine suction curettage. Five cases were referred from other hospitals where the initial management with uterine suction curettage had resulted in uncontrollable massive haemorrhage, 4 of the cases had UAE and one proceeded immediately to hysterectomy. In the 25 patients treated with prophylactic UAE and MTX, 12 had laparoscopy-guided curettage and 13 had ultrasound-guided curettage without complication. The results showed that the 25 patients with CSP, who received prophylactic UAE and MTX prior to uterine curettage, recovered without complications. Five patients referred from other hospitals, where uterine curettage was the primary procedure, had severe complications including uncontrolled vaginal bleeding and uterine rupture. Four of the five patients were treated successfully with emergency UAE and the remaining patient underwent emergency hysterectomy as ultrasound examination detected significant haemorrhage between the uterus and the bladder. Of the 25 patients who received prophylactic UAE combined with MTX, there were no reports of irregular menstruation or serious adverse effects. Notably, the decrease in serum human chorionic gonadotropin (HCG) levels 3 days post-surgery was greater with ultrasound-guided curettage (84.3±5.5%) than with laparoscopy-guided curettage (76.3±10.2%). In summary, the data suggested that prophylactic UAE with MTX followed by ultrasound-guided curettage is the most effective therapeutic approach in CSP.
AU  - Feng,Y
AU  - Chen,S
AU  - Li,C
AU  - Zhang,X
AU  - Duan,H
AU  - Sooranna,S
AU  - Johnson,MR
AU  - Li,J
DO  - 10.3892/etm.2016.3489
EP  - 1475
PY  - 2016///
SN  - 1792-1015
SP  - 1469
TI  - Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy.
T2  - Experimental and Therapeutic Medicine
UR  - http://dx.doi.org/10.3892/etm.2016.3489
UR  - http://hdl.handle.net/10044/1/40263
VL  - 12
ER  -
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